endemic goiter

A high instance of diffuse goiter in particular geographic areas involving more than 10% of the population. Thyroid gland enlarge- ment usually peaks at puberty & is more prevalent in men than in women. Etiology: 1) iodine deficiency 2) goitrogens Epidemiology: 1) common 2) affects > 2 million people worldwide 3) most prevalent in mountain areas a) Alps b) Himalayas c) Andes d) other areas remote from sea Pathology: 3) follicular cell hypertrophy & hyperplasia 4) enlargement of thyroid gland. Laboratory: 1) decreased serum T3, T4 2) increased serum TSH Management: - > during early stages of endemic goiter, iodine replacement results in regression of the enlarged thyroid gland, but later during the course of the disease, it is without effect on gland size

References

Cotran et al Robbins Pathologic Basis of Disease, 5th ed. W.B. Saunders Co, Philadelphia, PA 1994 pg 1131-32