P4-Thyroid Gland

- Causes of thyrotoxicosis.
- Thyroid receptor antibodies and grave’s pathogenesis.
- Diagnosis of thyroid disorders (lab investigations and thyroid scan)
Thyrotoxicosis
Hypermetabolic state (↑T4 and T3)
Commonly referred to as hyperthyroidism.
Pathogenesis of Grave’s disease:
 Most common cause of hyperthyroidism.
 Triad of manifestations: thyrotoxicosis, ophthalmopathy &
dermopathy.
 Diffuse hypertrophy, hyperplasia of follicles and lymphoid infiltrate.
 Autoantibodies binding to TSH receptors → stimulation of follicular
cells → ↑T4 and T3
 Pathogenesis of Grave’s disease:
1. Thyroid-stimulating immunoglobulin (TSI)
2. Thyroid-growth stimulating immunoglobulin
3. TSH-binding inhibitor immunoglobulin
 Diagnosis of thyroid disorders
1. TSH
2. T3
3. T4
4. Autoantibodies (TSI, TPOAb, TGAb& TRAb)
5. Thyroid scan
Diagnosis of thyroid disorders
TSH Free T4 Free T3
Thyrotoxicosis ↓ ↑ ↑
Primary ↑ ↓ or low-normal ↓ or normal
hypothyroidism
TSH deficiency ↓ or low-normal ↓ or low-normal ↓ or normal
Thyroid scan
 The isotope iodine 123 is ingested by
patient.
 Uptake: Increased (hyper), normal, or
decreased (hypo).
 The structure of the gland is visualized
showing size, location, and texture
(homogeneous or nodular)
Nodules can be hypo- or
hyperfunctioning.