anatomy

Wednesday, December 29, 2010

Signs and Symptoms

Most symptoms and signs are the same regardless of the cause. Exceptions include infiltrative ophthalmopathy and dermopathy, which occur only in Graves' disease.

The clinical presentation may be dramatic or subtle. A goiter or nodule may be present. Many common symptoms and signs of hyperthyroidism are similar to those of adrenergic excess, such as nervousness, palpitations, hyperactivity, increased sweating, heat hypersensitivity, fatigue, increased appetite, weight loss, insomnia, weakness, and frequent bowel movements (occasionally diarrhea). Hypomenorrhea may be present. Signs may include warm, moist skin; tremor; tachycardia; widened pulse pressure; atrial fibrillation and palpitations.

Elderly patients, particularly those with toxic nodular goiter, may present atypically (apathetic or masked hyperthyroidism) with symptoms more akin to depression or dementia. Most do not have exophthalmos or tremor. Atrial fibrillation, syncope, altered sensorium, heart failure, and weakness are more likely. Symptoms and signs may involve only a single organ system.

Eye signs include stare, eyelid lag, eyelid retraction, and mild conjunctival injection and are largely due to excessive adrenergic stimulation. They usually remit with successful treatment. Infiltrative ophthalmopathy, a more serious development, is specific to Graves' disease and can occur years before or after hyperthyroidism. It is characterized by orbital pain, lacrimation, irritation, photophobia, increased retro-orbital tissue, exophthalmos, and lymphocytic infiltration of the extraocular muscles, producing ocular muscle weakness that frequently leads to double vision.

Infiltrative dermopathy, also called pretibial myxedema (a confusing term, because myxedema suggests hypothyroidism), is characterized by nonpitting infiltration by proteinaceous ground substance, usually in the pretibial area. It rarely occurs in the absence of Graves' ophthalmopathy. The lesion is often pruritic and erythematous in its early stages and subsequently becomes brawny. Infiltrative dermopathy may appear years before or after hyperthyroidism.

Thyroid storm: Thyroid storm is an acute form of hyperthyroidism that results from untreated or inadequately treated severe hyperthyroidism. It is rare, occurring in patients with Graves' disease or toxic multinodular goiter (a solitary toxic nodule is less common and generally less severe). It may be precipitated by infection, trauma, surgery, embolism, diabetic ketoacidosis, or preeclampsia. Thyroid storm produces abrupt florid symptoms of hyperthyroidism with one or more of the following: fever, marked weakness and muscle wasting, extreme restlessness with wide emotional swings, confusion, psychosis, coma, nausea, vomiting, diarrhea, and hepatomegaly with mild jaundice. The patient may present with cardiovascular collapse and shock. Thyroid storm is a life-threatening emergency requiring prompt treatment.

Infiltrative Ophthalmopathy (Picture taken from Merk Manual)

Pretibial Myxedema in a Patient With Graves' Disease(Picture taken from Merk Manual)



3 comments:

  1. I have an enlarged goiter for more than 3 months...I'm presently taking desiccated bovine capsules to cure it. So far its making progress and I personally recommend it.

    ReplyDelete

  2. I started on COPD Herbal treatment from Ultimate Health Home, the treatment worked incredibly for my lungs condition. I used the herbal treatment for almost 4 months, it reversed my COPD. My severe shortness of breath, dry cough, chest tightness gradually disappeared. Reach Ultimate Health Home via their email at ultimatehealthhome@gmail.com . I can breath much better and It feels comfortable!

    ReplyDelete
  3. We tried to get pregnant for a few years in a local clinic. There were no results. We've tried everything possible but nothing. We were recommended to use eggs. I know we have to go abroad. I was terrified. I didn't know where to go and where to begin my search. When my friend recommended Dr Itua  to me from western Africa  I thought she was joking. I knew nothing about that country but I well know they have powerful gifts on herbal medicines and I was afraid because of the language barrier. Anyway she convinced me to give a try. She told me that Dr Itua can also cure my prostate cancer which gives me more motivation to give a try to Dr Itua herbal center medicines. I've done the research and thought that maybe this really is a good idea. Dr Itua has reasonable prices which I ordered two four bottles and I drank it as instructed and everything went well. My prostate cancer is gone. Also it has high rates of successful treatments. Plus it uses natural herbs. Well I should say I was convinced. We contacted Dr Itua and now we can say it was the best decision in our lives. We were trying for so long to have a child and suddenly it all looked so simple.  Dr Itua was so confident and hopeful he projected those feelings on me too. I am so happy to be a mother and eternally thankful to Dr Itua herbal Cure . Don’t be afraid and just do it! 
    Dr Itua can cure the following diseases:Sickle Cell,Hiv,Herpes,Shingles, Hepatitis B,Liver Inflammatory,Diabetes,Fibroid,Parkinson's,Alzheimer’s disease,Bechet’s disease,Crohn’s disease,Lupus,Hpv,Weak Erection,Infertility,fibromyalgia,Chronic Diarrhea,Get Your Ex Back,Als,SYPHILIS,Cancer,Autism,Genetic disease,Epilepsy, Parkinson's disease,  Doctor Itua Contact    Email:    drituaherbalcenter@gmail.com  Or Whats-App Chat : +2348149277967

    ReplyDelete