Breast and Endocrine Surgery
Kaji Sritharan, Samia Ijaz, Neil Russell, Tim Allen-Mersh in 300 Essentials SBAs in Surgery, 2017
The patient has a simple colloid/endemic goitre. A goitre is a diffuse or nodular enlargement of the thyroid gland. Symptoms may be due to compression, e.g. dysphagia, stridor, neck vein distension, dizziness on arm elevation (Pemberton’s sign), or to endocrine abnormalities, i.e. hypo- or hyperthyroidism. Goitres can be classified as sporadic or endemic and as toxic or non-toxic. The most common cause of endemic goitre is iodine deficiency and the presence of environmental or dietary goitrogens, e.g. vegetables of the Brassica family, such as cabbage. In England, endemic areas include the Chilterns, the Cotswolds, Derbyshire and Yorkshire, where iodide content of water and food has been historically low. Sporadic non-toxic goitres are typically asymptomatic; their cause is usually unknown but can include thyroiditis (e.g. post-partum, Riedel’s, Hashimoto’s), dyshormogenesis, drugs (i.e. goitrogens such as lithium), thyroid hormone resistance syndrome, genetic disorders (e.g. TSH receptor mutation), infiltration of the thyroid gland (e.g. sarcoidosis, amyloidosis) and malignancy.
Hypothyroidism
K. Gupta, P. Carmichael, A. Zumla in 100 Short Cases for the MRCP, 2020
I he common causes of hypothyroidism are: Chronic autoimmune thyroiditis (Hashimoto's thyroiditis).Post surgical resection or radio-iodine therapy for hyperthyroidism.Secondary to anti-thyroid drugs, e.g. carbimazole, etc. Other causes include: Diet with endemic goitre.Developmental abnormalities, e.g. agenesis and maldevelopment.Dyshormonogenesis.Hypopituitarism.
The minerals
Geoffrey P. Webb in Nutrition, 2019
The link between iodine deficiency and goitre was established early in the twentieth century by trials conducted by David Marine in the USA. Iodine fortification of salt is generally acknowledged as the first example of a successful food fortification programme. It began in Michigan in 1924 and within a year almost all Michigan homes used iodised salt. Between 1924 and 1936 incidence of goitre in Michigan schools dropped from 39% to 8%. Likewise, in those Swiss cantons with universal use of iodised salt, the incidence of goitre dropped rapidly and had almost disappeared by 1945. David Marine in 1915 proclaimed that “endemic goitre is the easiest known disease to prevent” yet many millions of people are still iodine deficient and it is still the leading cause of preventable mental retardation in children (De Benoist et al. 2008). Historical accounts of the eradication of endemic goitre can be found in a WHO monograph by Lowenstein (1960). Women and girls are more susceptible to goitre than males.
Clinical and ultrasound characteristics distinguishing benign and malignant thyroid nodules in Johannesburg, South Africa
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2023
Kershlin Naidu, Victoria Saksenberg, Nasrin Goolam Mahyoodeen
In Southern Africa, endemic goitre is usually associated with iodine deficiency. This was initially described in 1954 in a goitre belt extending from Limpopo province through Swaziland and Lesotho into the Eastern Cape.23 Prevalence rates of endemic goitre in Africa range between 1% and 90% depending on the study region.24 Mandatory iodinisation of table salt in South Africa was introduced on 1 December 1995 and the Iodine Global Network now classifies South Africa’s iodine intake as adequate.25 A retrospective review at the endocrine unit of Chris Hani Baragwanath Academic Hospital compared thyroid ultrasound features with FNA and histology results. There was good correlation between the ATA ultrasound classification and cytopathology and histopathology results.26 Non-diagnostic thyroid FNA rates in South African studies range between 9% and 10%.26,27
Prevalence and clinical relevance of thyroid autoantibodies in patients with goitre in Nigeria
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2019
OA Ojo, RT Ikem, BA Kolawole, OE Ojo, MO Ajala
In a study carried out by Olusi et al.8 4.6% of patients with goitre were found to have significantly positive autoantibody titres against thyroglobulin (Tg) while none of the 59 normal controls matched for age and sex had demonstrable autoantibodies. Isichei et al.,9 in a survey of endemic goitre in Jos, showed that goitre is highly endemic in the area with prevalence varying from 1% to 23%. Females showed a markedly higher prevalence of goitre. Though urine samples indicated that iodine excretion was similar to that in iodine-deficient areas of the world, no relationship was observed between the prevalence of goitre and urinary iodine. It could therefore not be concluded that the aetiology of endemic goitre in this area was associated with iodine deficiency. It was thus concluded that endemic goitre may be an interplay of multiple factors of aetiological importance. Okosieme et al.,10 in a study on the prevalence of thyroid antibodies in Nigerian patients, found that TgAb and TPOAb were found in 4% and 7%, respectively, of healthy adult controls, 11.6% and 76.8% of patients with GD, 25% and 12.5% of patients with toxic nodular goitre (TNG) and 9.52% and 14.29% of patients with simple non-toxic goitre (SNTG). The prevalence of thyroid autoantibodies found by Okosieme et al.10 was higher than that reported in previous studies in Africans.11,12 This may be due to the use of agglutination method in previous studies, a less sensitive method compared with enzyme-linked immunosorbent assay (ELISA), which was used by Okosieme et al.
Relationship between metabolic syndrome and nodular thyroid diseases
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2018
Seher Kir, Yusuf Aydin, Hulya Coskun
Turkey is an endemic goitre region, and goitres caused by iodine deficiency are an important public health problem. Duzce is a moderately iodine-deficient region in Turkey [5]. Nodular thyroid diseases are very common in Turkey, with a reported prevalence of thyroid nodules of 2–6% by palpation and 18% by ultrasound imaging in studies conducted in various regions [6,7].