Edema in hyperthyroidism
Primary hypothyroidism is divided into several stages:
- subclinical - the disease is asymptomatic, TSH is lowered, T4 is normal;
- obvious or manifest - characteristic symptoms of the disease are observed, the level of TSH is significantly reduced, and T4 is elevated;
- complicated - manifested by a lack of mass, psychosis, cardiac or renal insufficiency, atrial fibrillation, dystrophy of parenchymal organs, etc.
Causes of development
Hyperthyroidism (thyrotoxicosis) may be due togenetically. This pathology manifests itself in autoimmune disease of Graves (they are: Perry or Flanyani Syndrome, Basedova's disease or diffuse toxic goiter), when there is a uniform increase in the thyroid gland. Autoimmune etiology of the disease occurs in 80 percent of cases. With such a violation, antibodies that stimulate the thyroid gland and promote its increase and, accordingly, excessive secretion of thyroid hormones are produced.
Possible cause of hyperthyroidism may beseals in the thyroid gland of a local nature, for example, in nodular goiter. Multinodular goiter or even single nodes stimulate the activity of the thyroid gland, which in turn leads to an increased concentration of thyroid hormones in the blood.
Hyperthyroidism can be caused by viralinflammation of the thyroid gland (acute or subacute thyroiditis). In this case, the disease is of a non-severe and temporary nature, lasting from several weeks to several months.
Hyperthyroidism of drug etiology can develop with uncontrolled administration of thyroid hormones.
To the development of hyperthyroidism, women with an autoimmune pathology and a hereditary anamnesis are predisposed.
With hyperthyroidism, there are quite significant changes in the body.
Symptomatology depends on the degree of damage to the organ, system or tissue:
- There are quite pronounced violations withthe side of mental activity and the activity of the central nervous system: increased excitability and nervousness, emotional imbalance (tearfulness and irritability), quick speech and increased mental processes, small-scale tremor, anxiety and fear, insomnia.
- From the cardiovascular system: disturbance of the heart rhythm (flickering and fluttering of the atria, sinus tachycardia), lowering of the diastolic (lower) and increasing systolic blood pressure, development of heart failure, increased heart rate.
- Ophthalmic disorders in hyperthyroidismis found in about 45% of patients. Graves' ophthalmopathy is manifested by a rare blinking, protrusion of the eyeball forward (exophthalmos), enlargement of the eye gap, doubling of objects, restriction of mobility of the eyeball, the eyelids of the patient are edematic and hyperpigmented. There is erosion and dryness of the cornea, lacrimation and pain in the eyes. As a result of dystrophic changes in the optic nerve and its compression, blindness can develop.
- Especially noticeable in hyperthyroidism is the accelerationbasic metabolism and metabolic changes, characterized by increased appetite and at the same time a steady decrease in weight, increased heat production (heat intolerance, fever, sweating), the development of thyroid diabetic. In addition, as a result of rapid disintegration of cortisol, which occurs under the influence of thyroid hormones, adrenal insufficiency develops.
- The skin with hyperthyroidism becomes thin, moist and warm; hair early gray and thin; edema of the soft tissues of the lower leg develops; there are changes in the nails.
- There is shortness of breath and a decrease in the vital capacity of the lungs due to edema and stagnant phenomena in the lungs.
- From the gastrointestinal tract are observedthe following disorders: a violation of digestion and bile formation, increased appetite, unstable stool (diarrhea), an increase in the liver (before the appearance of jaundice in severe cases), attacks of pain in the abdomen. In elderly patients, there is often a sharp decrease in appetite leading to anorexia.
- There are violations of water metabolism, characterized by frequent and profuse urination and thirst.
- With hyperthyroidism, there are also signsthyrotoxic myopathy, such as muscle fatigue, muscle wasting, development of osteoporosis, trembling in the whole body and constant weakness, impaired motor activity, when patients experience great difficulties in climbing stairs and walking for long periods, when carrying cargo. Reversible "thyrotoxic muscle paralysis" may develop.
- In addition, with hyperthyroidism, as a resultviolation of the secretion of female and male gonadotropins, develops a disorder of the sexual sphere: in men - decreased potency and gynecomastia; in women - menstrual cycle disorders (poor allocation, soreness and irregularity), fainting and general weakness.
In the unfavorable course of this disease, thyrotoxic crisis may develop, which can be provoked by a great deal of physical stress, stress, or infectious diseases.
The crisis manifests itself in the aggravation of all symptomshyperthyroidism: severe tachycardia, fever, delirium, signs of heart failure, etc. Progression of this process can lead a patient to a coma and a lethal outcome. In addition, it is possible to "apathetic" version of the crisis - complete indifference, apathy, cachexia. It is worth noting that the thyrotoxic crisis occurs only in women.
Diagnosis of hyperthyroidism in the characteristic clinical manifestations - complaints in the collection of anamnesis and appearance of the patient, and according to the results of the research:
- Ultrasound of the thyroid gland - reveals the presence of nodal neoplasms in it, and determines its dimensions.
- Computer tomography (CT) - shows the place of formation of nodes.
- Electrocardiogram - fixes the presence of abnormalities in the cardiovascular system.
- The analysis of a blood on hormones (3, 4, TTG) - at a thyrotoxicosis the maintenance in a blood of hormones T3 and 4 is raised, and TTG, accordingly, is lowered.
- Scintigraphy of the gland is a radioisotope method that determines the functional activity of the thyroid gland.
- A node biopsy is a manipulation aimed at examining the tissues of the neoplasm.
In modern endocrinology, there are several methods of treating hyperthyroidism.
They can be used both in isolation and in combination with each other:
- Surgical method - removal of the thyroid gland or part of it.
- Conservative or drug therapy.
- Radioiodine therapy.
The choice of treatment is determined by the endocrinologistspecifically for each patient with hyperthyroidism, taking into account many factors: individual characteristics of the body, the age of the patient, the presence of concomitant diseases, allergy to drugs, a disease that caused hyperthyroidism and its severity.
Prognosis and prevention of hyperthyroidism
Patients with thyrotoxicosis should be in mandatoryorder to be observed at the endocrinologist. Correctly selected and timely treatment will allow you to quickly restore health and well-being, as well as prevent the development of various complications. Immediately after the diagnosis is established, adequate treatment should be started and categorically prohibited from self-medication.
Prevention of the development of this disease consists in the timely treatment of thyroid pathology, as well as in proper nutrition and use in a sufficient number of products containing iodine.