Goiter%20nontoxic%20(simple)--%20diffuse%20-and-%20multinodular Signs and Symptoms
Introduction
- Thyroid enlargement unrelated to hypothyroidism, hyperthyroidism, inflammation or neoplasia
Etiology
- Etiology is usually unknown
- Known causes include: Iodine deficiency, iodine excess, goitrogen ingestion, autoimmune disorders (eg Hashimoto's thyroiditis), thyroid hormone production defects and certain medications
- There is a female preponderance of nontoxic diffuse goiter
Signs and Symptoms
- Usually asymptomatic
- Symptomatic patient may present with the following:
- Painless neck swelling
- Cosmetic complaints
- Shortness of breath
- Sudden increase in goiter size with pain due to hemorrhage
- Large goiter causing obstructive signs eg dysphagia, choking sensation, stridor, plethora (venous congestion)
- Pemberton’s sign - faintness with facial congestion, external jugular venous blockage when both arms are raised above head (an action that draws the thyroid into the thoracic inlet)