Diffuse toxic goiter in children
Diffuse toxic goiter is a pathological condition that develops as a result of intensive work of the thyroid gland, which consists in the greater production of thyroid hormones and their entry into the blood.In this disease, various systems, organs, and metabolic processes are affected. In this regard, the manifestations of diffuse goiter differ in polymorphism. The first description of the disease in a five-year-old child is found in the medical literature in 1902. Since then, many works have been published on how the diffuse toxic goiter manifests itself and how it is treated. It is noticed that children’s age accounts for up to 6% of cases of this disease. Prone to him more often girls. Diffuse goiter develops predominantly in adolescence. This pathology is described in infants. There are also a few cases of congenital thyrotoxicosis.
Diffuse toxic goiter: etiology
Observations on the manifestations of the disease have shown that infection is often the cause of its occurrence in children.Diffuse toxic goiter may be preceded by sore throat, acute respiratory infections, scarlet fever, exacerbated chronic tonsillitis, diphtheria, mental trauma, hypothermia, excessive sun exposure. In 30% of cases the hereditary factor plays a large role.It should also indicate a special tendency to diffuse toxic goiter in adolescence. This is due to the instability of the endocrine system and the complex neurohumoral reorganization of the child’s body at this time.
Diffuse toxic goiter: symptoms
Three clinical manifestations are characteristic of thyrotoxicosis: enlargement of the thyroid gland, tachycardia, exophthalmos. The first symptom is observed in all cases of diffuse goiter. As a rule, or evenly increase both lobes of the gland and the isthmus, or just the right. Due to the accelerated blood flow, there are also vascular symptoms: pulsation and vibration when feeling, noise when listening. Gland enlargement is four degrees:
I - it is palpable, but it still can not be considered when swallowing;
II - during the absorption of food iron is already clearly visible;
III - it is noticeable and upon visual inspection, the neck thickens;
IV - too enlarged gland changes the outlines of the neck.
The next symptom - exophthalmos - is observed in more than 75% of cases. The degree of thyrotoxicosis and protrusion of the eyeball are not interrelated. With severe diffuse goiter exophthalmos may be mild and vice versa. This symptom remains even after surgery. It is significantly affected with thyrotoxicosis and the heart: there is tachycardia even during sleep, shortness of breath, a slight expansion of the organ.
Diffuse toxic goiter: treatment
The disease is moderate and severe requires children to stay in the hospital. To normalize the activity of the central nervous system, hypnotics and sedatives are used. Against the background of this therapy, it is necessary to administer antithyroid drugs that inhibit the formation of hormones in the thyroid gland and their entry into the blood. Combined therapy also includes vitamins. If a conservative treatment does not give a lasting effect, and a diffuse toxic goiter is of grade III-IV, the thyroid gland is resected.