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{{Toxic multinodular goiter}}
{{Toxic multinodular goiter}}
{{CMG}}; {{AE}}  
{{CMG}}; {{AE}}{{Ajay}}  
==Overview==
==Overview==
The majority of patients with toxic multinodular goiter are asymptomatic. However, they can present with symptoms such as swelling or pain in front of the neck, cough, shortness of breath, hoarseness, Diaphoresis, skin flushing, increased appetite, restlessness, nervousness, heat intolerance, tremors, palpitations, insomnia, anxiety, menstrual irregularities:
The majority of patients with toxic multinodular goiter are asymptomatic. However, they can present with symptoms such as swelling or pain in front of the neck, cough, shortness of breath, hoarseness, Diaphoresis, skin flushing, increased appetite, restlessness, nervousness, heat intolerance, tremors, palpitations, insomnia, anxiety, menstrual irregularities.
 
==History and Symptoms==
==History and Symptoms==
*The majority of patients with toxic multinodular goiter are asymptomatic.
The majority of patients with toxic multinodular goiter are asymptomatic. However toxic multinodular goiter can also present as below:<ref name="pmid3970328">{{cite journal |vauthors=Katlic MR, Grillo HC, Wang CA |title=Substernal goiter. Analysis of 80 patients from Massachusetts General Hospital |journal=Am. J. Surg. |volume=149 |issue=2 |pages=283–7 |year=1985 |pmid=3970328 |doi= |url=}}</ref><ref name="pmid3885887">{{cite journal |vauthors=Katlic MR, Wang CA, Grillo HC |title=Substernal goiter |journal=Ann. Thorac. Surg. |volume=39 |issue=4 |pages=391–9 |year=1985 |pmid=3885887 |doi= |url=}}</ref><ref name="pmid6648812">{{cite journal |vauthors=Allo MD, Thompson NW |title=Rationale for the operative management of substernal goiters |journal=Surgery |volume=94 |issue=6 |pages=969–77 |year=1983 |pmid=6648812 |doi= |url=}}</ref><ref name="pmid6648812">{{cite journal |vauthors=Allo MD, Thompson NW |title=Rationale for the operative management of substernal goiters |journal=Surgery |volume=94 |issue=6 |pages=969–77 |year=1983 |pmid=6648812 |doi= |url=}}</ref><ref name="pmid7661484">{{cite journal |vauthors=Torre G, Borgonovo G, Amato A, Arezzo A, Ansaldo G, De Negri A, Ughè M, Mattioli F |title=Surgical management of substernal goiter: analysis of 237 patients |journal=Am Surg |volume=61 |issue=9 |pages=826–31 |year=1995 |pmid=7661484 |doi= |url=}}</ref><ref name="pmid6831895">{{cite journal |vauthors=Torres A, Arroyo J, Kastanos N, Estopá R, Rabaseda J, Agustí-Vidal A |title=Acute respiratory failure and tracheal obstruction in patients with intrathoracic goiter |journal=Crit. Care Med. |volume=11 |issue=4 |pages=265–6 |year=1983 |pmid=6831895 |doi= |url=}}</ref><ref name="pmid11074902">{{cite journal |vauthors=Marqusee E, Benson CB, Frates MC, Doubilet PM, Larsen PR, Cibas ES, Mandel SJ |title=Usefulness of ultrasonography in the management of nodular thyroid disease |journal=Ann. Intern. Med. |volume=133 |issue=9 |pages=696–700 |year=2000 |pmid=11074902 |doi= |url=}}</ref><ref name="pmid11444166">{{cite journal |vauthors=Hegedüs L |title=Thyroid ultrasound |journal=Endocrinol. Metab. Clin. North Am. |volume=30 |issue=2 |pages=339–60, viii–ix |year=2001 |pmid=11444166 |doi= |url=}}</ref><ref name="pmid6648812">{{cite journal |vauthors=Allo MD, Thompson NW |title=Rationale for the operative management of substernal goiters |journal=Surgery |volume=94 |issue=6 |pages=969–77 |year=1983 |pmid=6648812 |doi= |url=}}</ref><ref name="pmid7661484">{{cite journal |vauthors=Torre G, Borgonovo G, Amato A, Arezzo A, Ansaldo G, De Negri A, Ughè M, Mattioli F |title=Surgical management of substernal goiter: analysis of 237 patients |journal=Am Surg |volume=61 |issue=9 |pages=826–31 |year=1995 |pmid=7661484 |doi= |url=}}</ref><ref name="pmid6831895">{{cite journal |vauthors=Torres A, Arroyo J, Kastanos N, Estopá R, Rabaseda J, Agustí-Vidal A |title=Acute respiratory failure and tracheal obstruction in patients with intrathoracic goiter |journal=Crit. Care Med. |volume=11 |issue=4 |pages=265–6 |year=1983 |pmid=6831895 |doi= |url=}}</ref><ref name="pmid22147633">{{cite journal |vauthors=Banks CA, Ayers CM, Hornig JD, Lentsch EJ, Day TA, Nguyen SA, Gillespie MB |title=Thyroid disease and compressive symptoms |journal=Laryngoscope |volume=122 |issue=1 |pages=13–6 |year=2012 |pmid=22147633 |doi=10.1002/lary.22366 |url=}}</ref>


===History===
===History===
[[a]] history of iodine intake (including country of origin), medication history, family history of benign or malignant thyroid disease, and history of head and neck irradiation or radioiodine exposure from nuclear power plant accidents (Chernobyl, Fukushima) should be obtained.
A history of iodine intake (including country of origin), medication history, family history of benign or malignant thyroid disease, and history of head and neck irradiation or radioiodine exposure from nuclear power plant accidents (Chernobyl, Fukushima) should be obtained.
===Common Symptoms===
===Common Symptoms===
* Common symptoms of thyroid adenoma include the following:<sup>[[Thyroid adenoma history and symptoms#cite note-.C4.B0lkay Kartal2014-1|[1]]]</sup>
* Common symptoms of toxic multinodular goiter include the following:<sup>[[Thyroid adenoma history and symptoms#cite note-.C4.B0lkay Kartal2014-1|[1]]]</sup>
* [[Swelling]] or [[pain]] in front of the [[neck]]
* [[Swelling]] or [[pain]] in front of the [[neck]]
* [[Cough]]
* [[Cough]]
* [[Shortness of breath]]
* [[Shortness of breath]]
* [[Dysphonia|Hoarseness of voice]]
* [[Dysphonia|Hoarseness of voice]]
:* Warm sweaty [[skin]]
* Warm sweaty [[skin]]
:* Skin flushing
* Skin flushing
:* Increased appetite
* Increased appetite
:* [[Weight loss]]
* [[Weight loss]]
:* [[Restlessness]]
* [[Restlessness]]
:* [[Nervousness]]
* [[Nervousness]]
:* Heat intolerance
* Heat intolerance
:* [[Tremors|Trembling hands]]
* [[Tremors|Trembling hands]]
:* [[Palpitations]]
* [[Palpitations]]
:* [[Insomnia]]
* [[Insomnia]]
:* [[Anxiety]]
* [[Anxiety]]
:* Increased bowel frequency
* Increased bowel frequency
:* [[Amenorrhea|Menstrual irregularities]]
* [[Amenorrhea|Menstrual irregularities]]
 
===Less Common Symptoms===
*


==References==
==References==

Latest revision as of 15:05, 13 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ajay Gade MD[2]]

Overview

The majority of patients with toxic multinodular goiter are asymptomatic. However, they can present with symptoms such as swelling or pain in front of the neck, cough, shortness of breath, hoarseness, Diaphoresis, skin flushing, increased appetite, restlessness, nervousness, heat intolerance, tremors, palpitations, insomnia, anxiety, menstrual irregularities.

History and Symptoms

The majority of patients with toxic multinodular goiter are asymptomatic. However toxic multinodular goiter can also present as below:[1][2][3][3][4][5][6][7][3][4][5][8]

History

A history of iodine intake (including country of origin), medication history, family history of benign or malignant thyroid disease, and history of head and neck irradiation or radioiodine exposure from nuclear power plant accidents (Chernobyl, Fukushima) should be obtained.

Common Symptoms

References

  1. Katlic MR, Grillo HC, Wang CA (1985). "Substernal goiter. Analysis of 80 patients from Massachusetts General Hospital". Am. J. Surg. 149 (2): 283–7. PMID 3970328.
  2. Katlic MR, Wang CA, Grillo HC (1985). "Substernal goiter". Ann. Thorac. Surg. 39 (4): 391–9. PMID 3885887.
  3. 3.0 3.1 3.2 Allo MD, Thompson NW (1983). "Rationale for the operative management of substernal goiters". Surgery. 94 (6): 969–77. PMID 6648812.
  4. 4.0 4.1 Torre G, Borgonovo G, Amato A, Arezzo A, Ansaldo G, De Negri A, Ughè M, Mattioli F (1995). "Surgical management of substernal goiter: analysis of 237 patients". Am Surg. 61 (9): 826–31. PMID 7661484.
  5. 5.0 5.1 Torres A, Arroyo J, Kastanos N, Estopá R, Rabaseda J, Agustí-Vidal A (1983). "Acute respiratory failure and tracheal obstruction in patients with intrathoracic goiter". Crit. Care Med. 11 (4): 265–6. PMID 6831895.
  6. Marqusee E, Benson CB, Frates MC, Doubilet PM, Larsen PR, Cibas ES, Mandel SJ (2000). "Usefulness of ultrasonography in the management of nodular thyroid disease". Ann. Intern. Med. 133 (9): 696–700. PMID 11074902.
  7. Hegedüs L (2001). "Thyroid ultrasound". Endocrinol. Metab. Clin. North Am. 30 (2): 339–60, viii–ix. PMID 11444166.
  8. Banks CA, Ayers CM, Hornig JD, Lentsch EJ, Day TA, Nguyen SA, Gillespie MB (2012). "Thyroid disease and compressive symptoms". Laryngoscope. 122 (1): 13–6. doi:10.1002/lary.22366. PMID 22147633.

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