Thyroid Diseases in brief…. part 2.

#Hypothyroidism #myxoedema

Hi friends,  I have acknowledge you all about Hyperthyroidism in my last post… Now in this I am going to share about Hypothyroidism.

Hypothyroidism is a clinical condition results from reduced production of thyroid hormone. When Hypothyroidism is of severe stage & long standing,  it is seen as myxoedema which is characterised by deposition of hyaluronic acid and mucopolysaccharides causing swelling of skin and of subcutaneous tissues.

 

 

Face in picture represents Myxoedema.

 

Causes of Hypothyroidism / Myxoedema : 

Primary Hypothyroidism

Acquired

  • Hashimoto’s Thyroiditis
  • Iodine deficiency
  • Drug induced
  • Goitrogens in foodstuffs
  • Cytokines

Congenital

  • Defect in iodine transport/utilisation
  • Thyroid peroxidase  (TPO) deficiency
  • Defect in thyroglobulin synthesis
  • Thyroid agenesis
  • TSH receptor defects
  • Idiopathic TSH unresponsiveness

Central Hypothyroidism

Acquired

  • Secondary  (pituitary origin)
  • Tertiary  (hypothalamic disorders)

Congenital

  • TSH deficiency
  • TSH receptor defect

Resistance to thyroid hormone
Clinical features : 

General – tiredness, weight gain, cold intolerance, goiter

Skin & subcutaneous tissues – dry skin , puffiness of face , baggy eyelids, Myxoedema – swollen oedematous appearance of neck, back of hands & feet , minimal sweating,  alopecia, vitiligo.

Respiratory /Cardiovascular – Bradycardia,  angina, cardiac failure, pleural effusion

Psychiatric features – depression  (myxoedema madness) , psychosis

Neuromuscular – aches & pains , carpal tunnel syndrome, cerebellar ataxia , muscle stiffness

Hematological – Iron deficiency anemia,  Macrocytic anemia,  pernicious anemia

Reproductive system – Infertility,  Menorrhagia, Impotence

Developmental – Growth retardation, mental retardation, delayed puberty

Investigation :

Thyroid function tests – 

  • reduced T4 , rise in serum TSH indicates primary hypothyroidism.
  • Reduced T4, With normal or below level of serum TSH suggests secondary hypothyroidism.

Serum cholesterol – Elevated in primary thyroid failure.

ECG – bradycardia 

Management

Replacement therapy : Thyroxine  (T4). Syptomatic improvement is seen within 2- 3 weeks of starting treatment.

Monitoring therapy : Restoration of T4 and TSH to normal level.

Hope you get some knowledge through this post.. Feel free to ask if you don’t understand medical terms….

Thank you for Reading.

☺Stay healthy, Stay happy ☺

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