Table 38-1 Differential Diagnosis of Hyperthyroidism

Increased Hormone Synthesis (Increased Release of Preformed Hormone

RAIU) (Decreased RAIU)
Graves' disease (diffuse toxic goiter) Toxic Thyroiditis—acute phase of Hashimoto's
multinodular goiter thyroiditis, subacute thyroiditis
Plummer's disease (toxic adenoma) Factitious (iatrogenic) thyrotoxicosis
Drug induced—amiodarone, iodine "Hamburger thyrotoxicosis"
Thyroid cancer
Struma ovarii
Hydatidiform mole
TSH-secreting pituitary adenoma
Table 38-2 Causes of Hypothyroidism
Primary (Increased TSH Secondary (Decreased TSH Tertiary
Levels)) Levels
Hashimoto's thyroiditis Pituitary tumor Hypothalamic insufficiency
RAI therapy for Graves' Pituitary resection or Resistance to thyroid
disease ablation hormone
Postthyroidectomy
Excessive iodine intake
Subacute thyroiditis

Medications: antithyroid
drugs, lithium
Rare: iodine deficiency,
dyshormogenesis
Table 38-3 Etiology of Nontoxic Goiter
Classification Specific Etiology
Endemic Iodine deficiency, dietary goitrogens
(cassava, cabbage)
Medications Iodide, amiodarone, lithium
Thyroiditis Subacute, chronic (Hashimoto's)
Familial Impaired hormone synthesis from enzyme
defects
Neoplasm Adenoma, carcinoma
Resistance to thyroid hormone -