Clinical case discussion - Goitre - Medical Examination

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There are different kinds of goitres. A simple goitre usually occurs when the thyroid gland is not able to produce enough thyroid hormone to meet the body's requirements. The thyroid gland compensates by enlarging, which usually overcomes mild deficiencies of thyroid hormone.

A simple goitre may be classified as either an endemic (colloid) goitre or a
sporadic (nontoxic) goitre.

Endemic goitres occur within groups of people living in geographical areas with iodine-depleted soil, usually regions away from the sea coast. People in these communities might not get
enough iodine in their diet. (Iodine is vital to the formation of thyroid hormone.) The modern
use of iodized table salt prevents this deficiency; however, it is still common in central Asia
and central Africa. Certain areas of Australia, including Tasmania and areas along the Great Dividing Range (for example, the Australian Capital Territory), have low iodine levels in the
soil.
In most cases of sporadic goitre the cause is unknown. Occasionally, certain medications such as lithium or aminoglutethimide can cause a nontoxic goitre.
Hereditary factors may cause goitres. Risk factors for the development of a goitre include female sex, age over 40 years, inadequate dietary intake of iodine, residence in an endemic area, and a family history of goitre.


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