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Paediatrics => Cretinism => Goitre
Goitre
INTRODUCTION
Goiter, disease of the thyroid gland, characterized by an enlargement of the gland, visible externally as a swelling on the front of the neck. In simple goiter the basal metabolic rate is somewhat lowered, and in toxic goiter it is elevated.
SIMPLE GOITER
This condition is characterized by an enlargement of the entire gland, or of one of its two lobes, caused by a deficiency of iodine in the diet. The disease is especially apt to appear in adolescence. Simple goiter occurs in inland areas of all continents. It was common in what was at one time referred to as the goiter belt of the U.S., which includes the Great Lakes region and inland mountain areas. The administration of iodine, or of the iodine-containing hormone thyroxine, effectively prevents the disease. Prevention requires taking small doses of iodine for long periods. Ingestion of iodine during pregnancy prevents development of the disease in the infant as well as in the mother. Public health measures, including the addition of iodine to water supplies and to table salt, have helped to reduce the incidence of simple goiter in certain areas. Iodine is most effective when administered to children who have the disease. Thyroidectomy, or surgical removal of the gland, may be necessary in cases in which the gland has become greatly enlarged.
TOXIC GOITER
This disease, also called exophthalmic goiter, hyperthyroidism, thyrotoxicosis, or Graves' disease, for the Irish physician Robert James Graves, is caused by an excess of thyroxine secretion. The cause of the excessive secretion is obscure. In some cases it may result from excessive stimulation by the pituitary gland. The symptoms of toxic goiter may include a rapid heartbeat, tremor, increased sweating, increased appetite, weight loss, weakness, and fatigue. Some patients have eye problems, such as staring or protrusion. Thiouracil and iodine are sometimes used in the treatment of toxic goiter, as is irradiation of the gland by radioactive iodine..
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