Diffuse toxic goiter (Graves' disease)

May 20, 2013

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Diffuse toxic goiter   (other name of this disease - Graves' disease . Graves's disease ) - A pathological process, which is characterized by an increase in Thyroid   diffuse character, in this case, patients have symptoms thyrotoxicosis .

Officially, diffuse toxic goiter described the first Irishman Robert James Graves   (1835), and German Carl Adolf von Basedow   (1840). It is called by their names in modern medicine disease.

Causes

This disease has an autoimmune nature. Its main feature - increased thyroid function ( hyperthyroidism ). Gradually shchitovidki size increases, and it produces much more thyroid hormones than during normal operation. It is generally accepted that the main mechanism of the autoimmune process in patients with diffuse toxic goiter is the production of specific immune system antibodies . As a result, the thyroid gland is too active a person constantly. The implication of this - increase in concentration in the patient's blood thyroid hormones.

Why Graves' disease leads to the appearance of such antibodies, scientists are still not precisely defined. There is a theory that in patients with Graves' disease in the body is "wrong" to TSH receptors. It is their immune system and defines as "outsiders." There is also a version that the main reason that a person overcomes goiter Graves is a defect in the immune system. As a consequence, the human immune system is not able to inhibit the immune response against the body's own tissues. Modern doctors are engaged in research aimed at identifying the role of different types of microorganisms on the development of the disease.

Furthermore, causes Graves disease, leading to its progression - is stresses . infectious diseases . trauma mental health .

Symptoms

Graves' disease is expressed in human features characteristic of hyperthyroidism. Symptoms of Graves' disease are determined by the fact that in the patient's notes the acceleration of metabolic processes. He says increased heart rate, diarrhea is often observed, is very active perspiration. There is also the stimulation of the nervous system that leads to the fact that a person becomes very irritable, and sometimes his hands tremble. Patients who developed Graves' disease, it does not tolerate the heat and sun.

Often the presence of appetite patient loses weight, because food that enters his body, has not kept pace too fast to compensate for the breakdown of proteins. Moreover, a large number of hormones, which are produced by the thyroid gland, causes too rapid disintegration of nutrients, which in turn leads to high energy costs. However, patients at a young age often increases the body weight, although it is showing signs of enhanced metabolism. Increased urination, which occurs when the disease often leads to dehydration. That is why the treatment of Graves' disease should be timely and correct.

Often goitre notes endocrine ophthalmopathy , Which is characterized by exophthalmia . Most often ophthalmopathy varying severity develops in diffuse toxic goiter. In most cases both eyes are affected, and the symptoms of the disease usually develop together with the main symptoms of toxic diffuse goiter. But sometimes ophthalmopathy develops sooner or later thyroid disease.

Increased production of thyroid hormones leads to changes in behavior, mood swings, there is a strong resentment, depression. Sometimes develop a phobia, but may also occur periodically condition euphoria . Sleep disorders accompanied by very frequent awakening, anxiety dreams.

Later, the patient appears goiter   - An increase in prostate tumor that noticeable to the naked eye. Thus there is swelling on the front of the neck, the doctor is easy to notice that during the inspection.

Accepted provide three degrees of severity of the disease. If mild hyperthyroidism indicated moderate symptoms, with severe hyperthyroidism in humans is amplified heartbeat, weight loss comes to a degree katehsii A person is suffering from weakness. If time does not cure the disease, it is possible to develop thyrotoxic crisis .

Diagnostics

If you suspect that the development of goitre is necessary to address to the doctor-endocrinologist. Basis for a comprehensive diagnosis - the presence of characteristic symptoms. The study carried out a laboratory blood test to determine the amount of thyroid hormones as well as titer of classical antibodies and thyroid function yodnakopitelnoy. If the physician visually determines that the thyroid gland is enlarged, the patients underwent an ultrasound scan.

Another study, which is practiced in suspected diffuse toxic goiter is much rarer, is fine-needle biopsy of the thyroid gland. Specialist take cells from the thyroid gland, using a thin needle. Then the cells are examined under a microscope. This procedure is suitable if the iron doctor identifies nodal education, which is easily palpable, or the size of a diameter of more than 1 cm.

In the process of diagnosing the patient should be aware that the increase in thyroid gland does not depend on the degree of severity of the disease.

Treatment

To date, there is no specific method of treatment particularly those processes that lead to the development of the disease. Graves' disease should be treated in such a way as to reduce the signs of hyperthyroidism. Initially, the treatment of diffuse toxic goiter involves receiving thyreostatics which selects the attending physician. In the process of receiving such medications symptoms, many patients become less pronounced. Drugs that decrease the production of thyroid hormones, necessarily prescribed to children and young people up to 25 years. Such drugs are used for treatment of patients in older age, as well as their need to take to reduce the symptoms of the disease before surgery.

However, the main problem in this case is the fact that immediately after the cancellation of such a preparation is often marked by a relapse of the disease, both adults and children. If there is a relapse, the patient is assigned to an operation in which there is a removal of the gland. This is called thyroidectomy. In addition to traditional surgery practice of destroying cancer cells using radioiodine .

Radioactive iodine patient takes capsules. The dose depends on the size of the crop. Gradually iodine accumulates in the thyroid cells, leading to their death. Before taking iodine patient stops taking thyreostatics funds. After treatment with radioactive iodine symptoms disappear after a few weeks. In some cases, re-treatment is appointed. Sometimes thyroid function is suppressed completely. Despite the fact that such treatment seems relatively easy and convenient, it is rarely used for the treatment of children and young people. Doctors wary refer to the probability of harmful effects of such treatment on the body as a whole. Although the application of this method within about forty years showed no adverse effects on other body systems.

The attending physician takes into account the fact that pregnancy Usually it improves the condition of patients whose disease is observed mild. However, sometimes the condition of the pregnant woman, on the contrary, is getting worse.

Symptoms of the disease are also effective in reducing medication from another group - beta-blockers. They are able to block the effects of too many hormones secreted by the thyroid gland, on the body, but directly to the thyroid not apply.

Surgical treatment is practiced at too large goiter, and with no effect after taking the medication. Thyroidectomy is performed in a hospital, then hospitalization lasts a few days.

Prevention

To prevent the development of goitre, it is necessary to observe the correct way of life, to prevent stress. It is important to observe these rules women during Menopause When the risk of hormonal failures increases. Patients with Graves' disease can not be in the sun, swim in the sea, take hydrogen sulfide baths. You should always try to keep composure, periodically visiting sanatorium with specialized treatment. Power should be patient enough nutritious, with a lot of carbohydrates. It is important to limit in the diet of animal protein, and rarely eat those foods that act on the body exciting (tea, coffee, spicy food, and others.). It is necessary to eat foods containing iodine: seaweed, seafood, vegetables and fruits.