Diffuse toxic goiter
Diffuse toxic goiter, Greaves-Bazedov’s disease, is usually referred to as Bazedov’s disease. This disease is systemic, autoimmune, which develops due to an increase in the secretion of thyroid hormones, which provokes the production of thyroid-stimulating hormone receptor antibodies. Due to the influence of these factors, thyroid gland damage, thyrotoxicosis and hormonal poisoning occur.
CAUSES OF BASEDOVA DISEASE
The cause of this disease is a combination of external and internal factors, that is, the immune reaction, which is caused at the genetic level, manifests itself with a certain combination of external factors. The disease belongs to the multifactorial group. A variety of factors can provoke a pathological mechanism:
The presence of bad habits;
Traumatic brain injuries;
Acute and chronic diseases of the larynx and nasopharynx;
Inflammatory and infectious diseases;
Stress, emotional and mental trauma.
SYMPTOMS OF BASEDOVA DISEASE
There are three main symptoms of Basedova disease: bug-eyed (exophthalmos), tachycardia and goiter. Since the thyroid gland in this state shows increased activity, there are many physiological functions that manifest themselves in the form of:
Disorders of the cardiovascular system (heart failure, systolic hypertension, tachycardia, arrhythmia);
Disorders in the central nervous system (headache, general weakness, tremor, insomnia, anxiety, anxiety);
Gastrointestinal disorders (regular diarrhea, sometimes nausea and vomiting);
Endocrine disorders (sudden weight loss with increased appetite, increased basal metabolism, intolerance to heat);
Dermatological disorders (excessive sweating, alteration and destruction of nail plates, swelling on the legs).
Changes in vision and eyes (lowering of the lower eyelid and lifting of the upper one, which provokes a defect in the visual fields, increased intraocular pressure, pain in the eyes or complete loss of vision);
Dental disorders (multiple caries or periodontal disease).
DIAGNOSIS OF BASAL DISEASE
The symptoms of this disease are developing rapidly, so patients seek medical help no later than 12 months after the onset of the pathological process.
In laboratory blood tests, a reduced concentration of thyroid-stimulating hormone in the blood is recorded. The most accurate information about Basedova disease is given by the determination of the titer of antibodies to the TSH receptor (AT-RTG).
In clinical blood analysis, in some cases, signs of normocytic or iron deficiency anemia are noted.
Biochemical analysis shows a decrease in the level of triglycerides and cholesterol, with an increase in hepatic transaminases.
Ultrasound of the thyroid gland records a diffuse increase in its volume, a significant increase in blood flow and hypoechoicity of its tissue.
Electrocardiography can be performed to confirm this disease.
TREATMENT OF BASEDOVA DISEASE
There are three treatment options for this disease:
conservative method;
surgical method;
therapy with radioactive iodine (131I).
With conservative treatment, thyrostatic drugs are prescribed. In some cases, this is enough, but if the disease does not respond to this method, surgical intervention is used or thyroid cells are destroyed by radioactive iodine.
Drug therapy is prescribed to patients with a slight increase in the thyroid gland, in the absence of nodes in it. To do this, thyrostatic drugs are used. In some cases, beta-blockers are used, which are designed to block the effect of excess thyroid hormones on the human body, but do not affect the gland itself.
Radioactive iodine therapy has proven its effectiveness with relative availability and the absence of significant complications. It is used for postoperative recurrence of thyrotoxicosis.
With a significant increase in goiter, surgical treatment is prescribed with subtotal resection of the thyroid gland, with a thyroid residue of no more than 2-3 ml.
