Diffuse goitre

Toxic diffuse goitre (Graves’-Basedow’s disease) indicates the thyroid gland’s hyperplasia and hyperfunction. Hereditary factors, infections, intoxications, psychemical traumas, etc., may also prompt that condition.

Factor

The foundation of pathogenesis is a disturbance of immune “supervision”, resulting in the formation of autoantibodies. They are a stimulating factor causing the gland’s hyperfunction, hyperplasia, and hypertrophy. To clarify, of significance here is the change in the sensitivity of tissues to thyroid hormones, leading to a disturbance of metabolism between them.

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What are the symptoms of Diffuse goitre?

The surplus of thyroid hormones affects different kinds of metabolism, organs and tissues. So, patients complain of irritability, weepiness, hyperrealism, insomnia, flaccidity, fatigue, sweating and hand and body tremors. Patients lose weight despite good appetite (limos). Young patients, on the contrary, may gain weight (“fat” Basedow). Furthermore, the thyroid gland can diffusely enlarge. However, there is no relationship between its enlargement and the seriousness of thyrotoxicosis.

Changes

Changes in the eyes are as follows:

• bilateral exophthalmia (no trophic disturbances),
• restricted movement of the eyeballs,
• Diffuse goitre symptom (the upper eyelid lags behind the eyeball when looking down),
• Dalrymple symptom (wide opening of the palpebral fissure),
• Mobius symptom (weakness of convergence),
• and Kocher’s symptom (retraction of the upper eyelid when shifting one’s gaze).

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