Adult Medical-Surgical Nursing Endocrine Module: Goitre
Goitre A goitre is an enlargement of the thyroid gland
Goitre: Classification and Aetiology Toxic goitre (hypersecretion): Grave’s disease, hyperthyroidism (auto-immune: thyroid-stimulating antibodies like TSH → hyperplasia and ↑ secretion) Non-toxic (hyposecretion): Hashimotos disease: hypertrophy related to growth-stimulating antibodies but hyposecretion (auto-immune thyroiditis) Increased TSH in response to hyposecretion of thyroid → enlarged gland Iodine deficiency (compensatory growth)
Goitre: Diagnosis Hormonal assays: TSH, T3, T4, FT4 Measure presence of thyroid antibodies Scan to measure uptake of radioactive iodine: I 131 Needle biopsy to rule out malignancy and auto-immune destruction of tissue
Goitre: Management If related to hyposecretion, treat with thyroxine to prevent further enlargement If related to iodine deficiency, treat cause If related to hyperthyroidism, treat the condition (anti-thyroid drugs, radiation therapy or surgery) If increased pressure symptoms, surgery may be necessary