what is the goître, kinds of the goître, goîtres tumoral and their signs, inflammatory goîtres and symptoms

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What is this?
This is the increase diffuses volume of the thyroid body. The goitre appears by a swelling of the former area of the neck. This affection is very frequent: 800 million people is reached by it in the world. The goitre can be homogeneous or heterogeneous including/understanding one or more cores.
We distinguishes:
The tumoral goitres which are irregular; the tumour can be benign or malignant
The inflammatory goitres which are seen during the thyroïdites
Vascular goitres of hyperthyroïdie (disease of Basedow)
The goitres with hypothyroïdie which are due to a disorder of the synthesis of the thyroid hormones
The simple goitres which correspond to an increase isolated from volume of gland, without tumour, ignition, without disorder of thyroid secretion.

Tumoral goitres The tumours of thyroid take several aspects. 80% of the patients are woman who consult for the increase in volume of the thyroid one. With palpation, the doctor perceives a single or several nodule.
Neither volume, neither consistency, nor the sensitivity make it possible to pose a diagnosis on the nature of the goitre. The doctor seeks signs of local compression:
Dysphonie: modification of the voice
Dysphagie: obstruct or pains while swallowing
Dyspnea: breathing difficulties
Pain

He also seeks existence of lymphatic ganglia of the neck hypertrophied. Complementary examinations impose it:

The radiography of the neck seeks calcifications or an extension of the goitre towards the thorax
The echography allows the diagnosis of thyroid cyst
The scintiscanning locates the lesions in the thyroid one and specifies of it is acts of lesions hyperfixantes (hot nodules) or beaches hypofixantes (cold nodules).

Inflammatory goitres
They are painful goitres spontaneously and with palpation. They are in general synonymous with thyroïdite
Vascular goitres: the disease of Basedow
A vascular goitre is recognized by clinical examination.
There exists a breath with sounding and a ” thrill” (impression of quivering) with palpation. In practice, these goitres with hyperthyroïdie is often the translation; a disease of Basedow

Goitres with hypothyroïdie
When the gland doesn’t secrete any more hormones or not enough, pituitary gland answers by an increase in secretion of TSH. This hypophyseal hormone hyperstimule the gland which grows bigger but which doesn’t succeed therefore increasing its synthesis of thyroid hormones. This defect of hormonal production can be due:
With an acquired or congenital enzymatic blocking (disorders of hormonogénèse)
With an after-effect of thyroïdite
With simple goitres.

They are most frequent. It is acts in general of young woman consulting their doctor for an increase in volume of the neck. A particular geographic origin is frequently found: Kabylie and in France: Alsace, Massif Central, the Pyrenees, the Alps, Brittany, the Ardennes. The family predisposition is clear.

The causes of increase in volume of thyroid are numerous, but to make a goitre, it is necessary for a moment given to have secreted an significant amount and prolonged TSH in answer to a secretary insufficiency; this adaptation of thyroid makes it possible to maintain a normal level of thyroid hormones in blood. The initial secretary insufficiency is in general due to a disorder of the hormonal synthesis, nutritional origin generally:
Deprive chronic iodizes (this is the traditional ” cretin of Alpes”)
Intoxication by factors goitrogenes: Cabbages, turnips, crucifères (thiocyanate)
Onions and garlic (disulphides)
Millet and sorghum (flavonoïdes)
Marine algas rich in iodine
Pollutants of water ” drinkable”
Certain drugs: aminosalicylic acid, sulfonylurée, lithium…

The goitre is clinically insulated: there doesn’t have tumour, not vascular character, not of sign of hypo nor of hyperthyroïdie. The goitre is diffuse, of variable volume, firm or soft but never hard. It increases sometimes, inflating and deflating during the episodes of the genital life (rules, pregnancy), of the stresses and the emotions. Some goitres evolve to the formation of cold nodules. The complementary examinations are normal:
T3 and T4: normal levels
Normal scintiscanning.

Theoretically, hypertrophy gland supposes an hypophyseal hyperstimulation, however very often the rate of plasmatic TSH is normal. These goitres known as simple is due to a very light deficit of the thyroid secretion which involves a hypersecretion of hypophyseal TSH consequently and thus the hyperplasy in return of the thyroid one. The hormonal defect and hypersecretion of TSH are very difficult to highlight. However, the treatment of these goitres rests on administration of thyroid hormones. When the simple goitre is of awkward volume, the medical care is proposed.

This isn’t never iodize which is prescribed. They are always thyroid extracts or thyroxine. The treatment is maintained with life. It is as much more effective that it is started early. Its effectiveness is judged on the reduction in volume of the goitre. Apart from the nodular goitre whose nodule can be cancerous, the simple goitre is a benign affection.