Toxic Nodular Goiter

Toxic nodular goiter (Plummer disease) is hyperthyroidism caused by one or more autonomously functioning thyroid nodules arising in long-standing nodular goiter. It occurs in older patients; hyperthyroid symptoms are often milder than in Graves disease and infiltrative ophthalmopathy is absent. Autonomous nodules show hot uptake on scintigraphy; suppressed surrounding tissue. Treatment: radioiodine or surgery; thionamides only for pretreatment.

Common Symptoms

Hyperthyroid symptoms (palpitations, weight loss, heat intolerance); multinodular goiter; atrial fibrillation in elderly; no ophthalmopathy

Causes and Pathogenesis

Somatic TSH-receptor/GS-alpha mutations in nodules cause autonomous hormone production independent of TSH; surrounding tissue is suppressed.

Treatment

Radioiodine; surgery; thionamide pretreatment; beta-blockade

Preventive Measures

Monitor nodular goiter function; screen older patients for atrial fibrillation.

Department to Visit

It is recommended to visit the Endocrinology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.