aetiology
Last reviewed 01/2018
Causes of goitre include:
- physiological:
- puberty - increased metabolic demand
- pregnancy - increased demand; increased TBG
- physiologic stress of any kind
- autoimmune:
- Graves' disease
- Hashimoto's thyroiditis
- thyroiditis:
- subacute granulomatous / de Quervain's
- subacute lymphocytic / silent
- Riedel's thyroiditis - uncommon; gland usually shrinks
- acute infective - transient
- infiltrative e.g. sarcoidosis, tuberculosis
- iodine deficiency - simple, endemic goitre
- idiopathic - simple, sporadic goitre
- multinodular goitre - develops from simple goitre
- dyshormogenesis - including Pendred's syndrome:
- inability to use trapped iodine
- deficiency of peroxidase and dehalogenase
- abnormal protein binding in the plasma
- goitrogens
- thyroid cysts - rare
- thyroid tumours
Note:
- a new area of enlargement within a goitre may indicate haemorrhage into a cyst, or a thyroid carcinoma