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2.1
Congenital Goiter
Struma Neonatal

Presentation

This conclusion was confirmed by analysis of proteins present in goiter extracts. [ncbi.nlm.nih.gov]

Topic Resources Congenital goiter is a diffuse or nodular enlargement of the thyroid gland present at birth. Thyroid hormone secretion may be decreased, increased, or normal. Diagnosis is by confirming thyroid size with ultrasonography. [msdmanuals.com]

Many children with goiters are euthyroid, but some present with hypothyroidism or hyperthyroidism. Diagnosis If the diagnosis of congenital goiter is suspected, thyroid size is typically assessed by ultrasonography. [merckmanuals.com]

Entire Body System

  • Goiter

    Abstract Eighty-four term newborn infants without goiter and 45 newborn infants with congenital goiter were studied with regard to thyroid function. The radiologic development of the femoral and tibial epiphyses was evaluated in those with goiter. [ncbi.nlm.nih.gov]

  • Myxedema

    E03.9 Hypothyroidism, unspecified Inclusion term(s): Myxedema NOS Abbreviations used here: NEC Not elsewhere classifiable This abbreviation in the Tabular List represents “other specified”. [icd10coded.com]

    Clinical symptoms include severe mental retardation, impaired skeletal development, short stature, and myxedema A deficiency of thyroid hormone present at birth. [icd9data.com]

    Myxedema Myxedema (hypothyroidism) belongs to a type of goiter that is caused by the reduced formation of thyroid hormone. [hyperthyroidismsymptomsx.com]

    […] goiter Inclusion: Congenital parenchymatous goiter (nontoxic)| Congenital goiter (nontoxic) NOS| excludes: transitory congenital goiter with normal function (P72.0)| E03.1 Congenital hypothyroidism without goiter Inclusion: Aplasia of thyroid (with myxedema [codelay.com]

    NOS congenital (without goiter) E03.1 ICD-10-CM Diagnosis Code E03.1 Congenital hypothyroidism without goiter 2016 2017 2018 2019 Billable/Specific Code Applicable To Aplasia of thyroid (with myxedema) Congenital atrophy of thyroid Congenital hypothyroidism [icd10data.com]

  • Fever

    Some common symptoms of thyroiditis include mild fever and neck pain that is worse with swallowing. Pregnancy - During the first tri-mester of pregnancy, a hormone called human chorionic gonadotrophin (HCG) can result in an enlarged thyroid gland. [nativeremedies.com]

Respiratoric

  • Dyspnea

    He presented with a voluminous multinodular goiter with tracheal compression causing dyspnea. [atm.amegroups.com]

Neurologic

  • Apathy

    […] activity intolerance r/t weakness and apathy secondary to a decreased metabolic rate AEB heart rate of 100 and SOB with activity -risk for injury: myxedema coma r/t hypersensitivity to anesthetic, sedatives, and opiods secondary to decreased metabolism [quizlet.com]

Workup

[…] in a young individual (often diagnosed due to routine screening of newborns for congenital hypothyroidism) Radiologic evaluation includes thyroid ultrasound and scintiscan Correlation of clinical signs with laboratory and ancillary tests Laboratory workup [pathologyoutlines.com]

[…] lateral radiograph of the knee may be obtained to look for the distal femoral epiphysis; this ossification center appears at about 36 weeks' gestation, and its absence in a term or postterm infant indicates prenatal effects of hypothyroidism. [16] See Workup [emedicine.medscape.com]

Treatment

The goiter is thought to be caused by intrauterine iodine deficiency, because hypothyroid values of T4 and TSH normalized during iodine treatment. General iodine prophylaxis of the population is recommended. [ncbi.nlm.nih.gov]

Treatment Surgical treatment of enlargement causing symptoms related to compression Sometimes thyroid hormone Hypothyroidism is treated with thyroid hormone. Goiters that compromise breathing and swallowing can be treated surgically. [merckmanuals.com]

Treatment is with synthetic thyroid hormone, taken every day. [icdlist.com]

In all reported cases, thyroxine treatment led to shrinkage of the goiter, reduction in amniotic fluid volume (in cases of polyhydramnios), and normalization of fetal thyroid function. [thyroidmanager.org]

[…] function in order for early treatment to be initiated if necessary. [radiopaedia.org]

Prognosis

Prognosis The prognosis of infants started on treatment early is excellent, with IQs similar to sibling or classmate controls. [orpha.net]

[…] thyroid used in conjunction with other findings: e.g. bone maturation and fetal heart rate, to determine the etiology Postnatal ultrasound diffusely and homogeneously enlarged thyroid gland +/- mass effect and narrowing of the trachea Treatment and prognosis [radiopaedia.org]

Without treatment patients die at birth, otherwise prognosis is excellent with thyroid hormone supplementation (1). Follicular adenoma can occur in thyroids with DG (5). [path.upmc.edu]

Invasive mediastinal tumors have a very poor prognosis, but this tumor located in mediastinum is very rare, so unfortunely aren’t many data about it, and estimated survival for this patient. [romanianjournalcardiology.ro]

Etiology

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

Etiology Congenital goitres may be a result of hereditary or non-hereditary causes (see differential diagnosis). [radiopaedia.org]

In the US, however, Hashimoto's and Graves' disease are more common etiologies. Goiters can be classified based on their morphology, function, or dignity (benign or malignant). Symptoms depend on etiology and are often absent. [amboss.com]

Etiology Congenital goiters may be caused by dyshormonogenesis (abnormal thyroid hormone production), transplacental passage of maternal antibodies, or transplacental passage of goitrogens. Some causes of congenital goiter are hereditary. [merckmanuals.com]

The etiology of TD, which is the most common cause of CH, is largely unknown. [dovepress.com]

Epidemiology

Epidemiology References: [1] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

Summary Epidemiology Thyroid dyshormonogenesis accounts for 10-15% of permanent congenital hypothyroidism (see this term). Clinical description Clinical manifestations are those of other forms of congenital hypothyroidism (see this term). [orpha.net]

However, studies have reported a change in the epidemiology, with a doubling in incidence to around 1 in 1500 live newborns. [1, 2] This is thought to be due in part to an increase in congenital hypothyroidism with thyroid gland-in-situ (GIS). [3] Lower [emedicine.medscape.com]

The aim of the present study was to determine whether a collection of Byzantine icons may be a useful source for the study of the epidemiology of particular visible diseases. Figure 2. Virgo Hodegetria. 13th century, icon. [hormones.gr]

Sometimes a partial or complete thyroidectomy is required. [15] Epidemiology [ edit ] Disability-adjusted life year for iodine deficiency per 100,000 inhabitants in 2002. [16] no data fewer than 50 50–100 100–150 150–200 200–250 250–300 300–350 350–400 [en.wikipedia.org]

Pathophysiology

Essentials of pathophysiology: Concepts of altered health states (3rd ed.). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins. ^ Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson (2007). [en.wikipedia.org]

after thyroid dysgenesis F > M (2:1) Mean age at surgery is 16 years (range varies from neonates to sixth decade), with 80% cases occur before 25 years No racial or ethnic predilection ( Thyroid 2011;21:13 ) Sites Diffuse involvement of both lobes Pathophysiology [pathologyoutlines.com]

Pathophysiology The thyroid gland develops from the buccopharyngeal cavity between 4 and 10 weeks' gestation. The thyroid arises from the fourth branchial pouches and ultimately ends up as a bilobed organ in the neck. [emedicine.medscape.com]

[…] www.genetests.org ] EuroGentest: [ http://www.eurogentest.org ] Perry R, Heinrichs C, Bourdoux P, Khoury K, Szots F, Dussault JH, Vassart G, Van Vliet G: Discordance of monozygotic twins for thyroid dysgenesis: implications for screening and for molecular pathophysiology [ojrd.biomedcentral.com]

Prevention

Inhibitors of proteasomal proteolysis and ER mannosidase-I both prevented ER-associated degradation of the Tg-R19K mutant and increased its association with ER molecular chaperones. [ncbi.nlm.nih.gov]

It was obvious that, in order to discover the causes of congenital malformations and cast strategies for their prevention, it would be necessary to have knowledge of the baseline of their frequency, and that this required uniformity of definition of terms [books.google.com]

The iodine deficiency can result in maternal and fetal hypothyroidism, preventing the partially protective transfer of maternal thyroid hormones. [clinicalgate.com]

You can treat goiter with iodine tinctures, but prevention is better. [animals.mom.me]

If a disorder prevents the thyroid gland from responding normally by increasing hormone output, the increased stimulation by TSH causes the thyroid gland to enlarge. [msdmanuals.com]

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2.1
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