Thyroid diseases with euthyroidism

Thyroid diseases with euthyroidism can be characterized as thyroid disease without impaired metabolism and function. It most often occurs in the form of eufunctional goitre, which may not cause any clinical manifestations for the affected person.

Eufunctional goitre

The term goitre refers to an enlargement of the thyroid gland above the volume standard, which is 18 ml for women and 22 ml for men. These values are geographically dependent, there are endemic areas where the values need to be adjusted. However, the presence of goitre does not necessarily indicate a metabolic disorder in the direction of hyperthyroidism or hypothyroidism. Eufunctional goitre produces a sufficient amount of thyroid hormones, there are no clinical manifestations of deficiency or excess.

Classification

By structure:

• diffuse,
• nodular,
  • uninodular,
  • polynodose.

Dle etiopatogeneze:

• dyshormonogenetic goitre (disorder of thyroid hormone metabolism),
• endemic goitre (caused by iodine deficiency in the diet),
• inflammation-induced goitre,
• tumor-induced goitre (benign or malignant).

The clinical picture

• Enlargement of the gland, which may or may not be palpable,
• Significant magnification can be seen at first glance,
• Sometimes goitre spreads retrosternally and is diagnosed by one of the imaging methods,
• Emergence of various compression syndromes (jugular veins, upper vena cava).

Diagnosis

• Anamnesis and physical examination (palpation, inquiries about the subjective feeling of pressure on the neck),
• Laboratory examination of hormones TSH, fT₃, fT₄, antibodies to exclude other etiology of goitre,
• Ultrasound,
• In case of uncertainty targeted FNAB (thin needle aspiration biopsy under ultrasound control).

Treatment

• Observations in asymptomatic goitre,
• During mechanical oppression or deviation of the surrounding structures (vessels, trachea), srugical treatment (strumectomy) is started,
• Thyroid hormone replacement therapy is no longer performed, has not led to a significant reduction in volume and, in addition, has threatened complications from iatrogenic mild hyperthyroidism.

References

Related articles

• Thyroid
• Hyperthyroidism
• Hypothyroidism
• Thyroid tumors
• Examination of thyroid function

Used literature

• ČEŠKA, Richard. Internal. 1. edition. Triton, 2010. ISBN 978-80-7387-423-0.