HYPERTHYROIDISM

THYROID GLAND

 Thyroid is a small, butterfly-shaped gland located at the front of your neck under
your skin. It’s a part of your endocrine system and controls many of your body’s
important functions by producing and releasing (secreting) certain hormones.
THYROID HORMONES SECRETION
HORMONES OF THYROID GLAND

 Thyroxine or tetraiodothyrinine(T4).90%secreted by follicular cells

 Triiodothyronine(T3).10% secreted by follicular cells

 Calcitonin secreted by parafollicular cells

 HYPERTHYROIDISM

 The overproduction of a hormone by the butterfly-shaped gland in the neck (thyroid).

 Hyperthyroidism is the production of too much thyroxine hormone. It can increase

metabolism.
HYPERTHYROIDISM

 Hyperthyroidism is a set of disorders that involves excess

synthesis and secretion of thyroid hormones by the thyroid
gland which leads to an hypermetabolic state called
thyrotoxicosis
THYROTOXICOSIS

 Thyrotoxicosis is a clinical state of inappropriately high levels of circulating thyroid

hormones (T3 and/or T4) in the body from any cause.

 Hyperthyroidism is characterised by increased thyroid hormone synthesis and

secretion from the thyroid gland, whereas thyrotoxicosis refers to the clinical
syndrome of excess circulating thyroid hormones, irrespective of the source.
INCIDENCE

 Hyperthyroidism is more common in women and people older than 60.

You are more likely to have hyperthyroidism if you have a family history of thyroid disease
have other health problems, includingpernicious anemia NIH external link, a condition
caused by a vitamin B12 deficiencytype 1 or type 2 diabetesprimary adrenal insufficiency, a
disorder of hormoneseat large amounts of food containing iodine NIH external link, such as
kelpuse medicines that contain iodineuse nicotine products3were pregnant within the past 6
months
CAUSES OF HYPERTHYROIDISM
 Graves disease
 Solitary toxic nodule
 Plummers disease
 Jod basedow phenomenon
 TSH secreting pituitary adenocarcinoma
 Struma ovarii
GRAVES DISEASE
 Common cause of hyperthyroidism
 Autoimmune condition where antibodies act against thyroid receptors long acting thyroid stimulating antibodies
 Clinical features
 Diffuse enlargement of thyroid gland
 Tremors
 Eye signs
1. Exopthalmous
2. Stellwags sign infrequent blinking
3. Dalrymples sign –lid retraction with visible upper sclera
4. Von graphes sign-lid lag on down gaze
5. Joffroi sign-Absence of forehead wrinkling on update
6. Moebius sign-loss of accommodation reflex
 Pretibial myedema
 Acropachy swelling of digits and dermopathy
THYROIDITIS

 Thyroiditis is inflammation of your thyroid gland. Some types of thyroiditis can cause
thyroid hormone to leak out of your thyroid gland into your bloodstream. As a result, you
may develop symptoms of hyperthyroidism.
 The types of thyroiditis that can cause hyperthyroidism include
 subacute thyroiditis, which involves a painfully inflamed and enlarged thyroid.
 postpartum thyroiditis, which can develop after a woman gives birth.
 painless thyroiditis, which is similar to postpartum thyroiditis, but occurs in the absence of
pregnancy. Your thyroid may be enlarged. Experts think painless thyroiditis is probably an
autoimmune condition.
TOXIC MULTINODULAR GOITER
TOXIC ADENOMA
 CLINICAL FEATURES OF
HYPERTHYROIDISM

Thin
Irritable
Heat intolerance
Weight loss inspire good appetite
Tachycardia and palpitations
Diaarohoea
Tremors
Oligomennorhoea

Thyroid function test-Raised T3 and T4 reduced TSH

DIAGNOSTIC TEST
 THYROID SCAN

 Graves disease - diffuse increase in uptake

 Solitary toxic nodule -single hot nodule
 Toxic nodular goiter –Multiple hot and cold nodules
 Jod basedow phenomenon-increased uptake
 TSH secreting pituitary adenoma-diffuse increase in uptake
 Struma ovarii-decresed uptake in thyroid gland
MANAGEMENT