Update: October 2018
Thyroid hyperplasia is a pathological condition
characterized by an increase in organ size accompanied by
violations of its functions. There are diffuse and nodal
Diffuse hyperplasia of the thyroid gland is
uniform, symmetrical organ enlargement. Over time, most
such states goes into a nodal form.
Single or common nodes cause uneven
enlargement of the gland. Their appearance indicates the progression
diseases. Hyperplasia may not be accompanied by visible
increase in size or swelling in the neck. However, even
a slight enlargement of the gland is capable of causing
symptoms associated with compression of the surrounding organs.
Approximately 740 million have this condition.
inhabitants of the earth. Its prevalence depends on the region of residence:
32% – east of the Mediterranean, 20% – Africa, 15% – Europe,
Southeast Asia – 12%, the western coast of the Pacific Ocean – 8%,
America – 5%.
Causes of hyperplasia
Thyroid hyperplasia is a condition associated with
insufficient hormone secretion. With a lack of hormones
thyroid gland activation occurs complex compensatory
hypothalamic-pituitary system, which leads to increased
gland stimulation. As a result of over-stimulation with thyroid-stimulating
thyroid cell hormones can increase significantly
in size (15-20 times).
Causes of hormonal disorders are:
- Insufficient iodine intake
- Goiter Hashimoto
- Immunity disorders
- Congenital hormonal disorders
- Acceptance of hormonal and other drugs that depress work
- Pituitary or hypothalamus tumor
- Злокачественные опухоли thyroid gland
Iodine deficiency is the most common cause of hyperplasia.
thyroid gland во всем мире. It was believed that the production
iodized salt will solve the problem, but at this time about 2
Billions of people on Earth still lack iodine.
In some cases it is not possible to find out the reason
hyperplasia. This condition is called idiopathic hyperplasia.
thyroid gland. There is evidence that its indirect cause
are inflammatory diseases of the body.
Factors predisposing to the development of hyperplasia,
- Gender and age (women and older people over
подвержены заболеваниям thyroid gland). The risk is significant
increases during pregnancy and menopause;
- The presence of autoimmune or oncological diseases in relatives
- Medication (immunosuppressants,
antiretroviral drugs, amiodarone,
drugs used in psychiatric practice);
- Radiation exposure (related to the type of activity or
radiotherapy in the chest and neck).
Симптомы гиперплазии thyroid gland
Гиперплазия thyroid gland может длительное время протекать
without clinical manifestations, without causing the patient unpleasant
sensations. With the increase in the size of the body begin to appear
initial symptoms, and in the absence of iron treatment increases
so much so that it leads to serious disturbances in swallowing and breathing.
According to the American Association of Endocrinologists, symptoms
compression of surrounding structures are rarely observed and more pronounced in
older patients with a long-term current disease. TO
These symptoms include:
- Difficulty swallowing (enlarged gland squeezes
the esophagus, making it impossible to swallow large chunks of food or even
pills. The patient feels a “lump in the throat” that does not pass.
- Respiratory failure (if the enlarged gland squeezes the trachea and
blocking the airways, patients feel
�”Lack of air” and other breathing disorders, especially during
exercise and supine);
- The change in timbre of the voice (in case of compression of the nerve going to
vocal cords, there are various changes in the voice
hoarseness or lower timbre. This is usually seen in people
which are often and often spoken, for example, by teachers);
- Impaired blood flow in the area of the enlarged gland (with
a significant increase in iron squeezes blood vessels in
neck area. Patients feel swelling of the neck veins, redness
faces and shortness of breath).
- Pain (with an increase in the size of the gland and damage to the blood
vessels may develop bleeding causing painful
sensations. A sign of bleeding is a sudden increase
glands and an increase in respiratory disorders).
Узловая гиперплазия thyroid gland характеризуется развитием
- Increased blood pressure, arrhythmias;
- Depressive states, irritability, panic attacks,
- Sleep disturbance
- TOолебания веса
The above symptoms increase depending on the degree
- 0 degree – started process, characterized by only
changes in hormonal levels, without external manifestations;
- Гиперплазия thyroid gland 1 степени – увеличение не
It is externally manifested, but there is a marked gland isthmus
swallowing, as well as he palpable palpable;
- Гиперплазия thyroid gland 2 степени характеризуется видимым
an increase in organ size, excretion of the whole gland at
- Гиперплазия thyroid gland 3 степени – это стадия, при
which there is a significant change in the appearance of the patient
(it becomes clearly noticeable increased education in the field
neck, changing its shape);
- Гиперплазия thyroid gland 4 степени – это запущенная стадия
diseases characterized by a significant change in shape
neck caused by a significant increase in organ size;
- The transition to the 5th degree is characterized by the appearance of characteristic
symptoms of compression of the trachea and esophagus, develop pronounced
soreness due to compression of nerve endings and
damage to surrounding tissues.
Гиперплазия thyroid gland у детей может быть заподозрена по
- Lag in physical development;
- Changing attitudes towards peers, aggressiveness;
- Decrease in school performance.
The diagnosis is confirmed laboratory, to increase the level
thyroid-stimulating hormone in the blood. It is necessary to take into account
age standards for children of different ages.
Лечение гиперплазии thyroid gland
Therapeutic measures are selected after a thorough examination.
и зависят от причины diseases. Most timely
выявленных случаев гиперплазии thyroid gland лечатся
conservatively. If the gland is enlarged moderately or slightly, then
For the treatment of used substitution therapy tablets
forms of hormonal drugs.
Гормональное treatment гиперплазии thyroid gland предполагает
восполнение дефицита гормонов thyroid gland. Consequence
normalization of the condition is the normalization of hormone production,
stimulating the work of the gland, and its growth stops. This principle
therapy does not always lead to a decrease in the size of the gland, but
effectively prevents its further increase. If conducted
treatment не приносит желаемого эффекта, альтернативным способом
является операция (удаление thyroid gland).
The indication for surgery is also a significant increase.
glands, accompanied by the appearance of symptoms of tracheal compression and
esophagus. The decision to conduct surgical treatment should
производиться only после инструментального подтверждения роста
thyroid gland и сдавления органов (рентген, компьютерная
tomogram in the cervical region).
An additional factor determining the need for surgery,
is suspected malignant process. Worth considering
what’s the chance of going to cancer from hyperplasia
thyroid gland составляет менее 5%.
Another reason for the surgical treatment of hyperplasia
is a cosmetic intervention. In rare cases
patients require surgery to remove an enlarged gland,
видимой в виде образования в neck area. With this symptoms
compression of the trachea or esophagus may not be.
In some cases, radioactive iodine is used for treatment.
This method allows you to control growth through directional
воздействия на клетки thyroid gland. Treatment result
is a reduction in the size of the gland. A feature of the method is
the need for subsequent supportive therapy with synthetic
Sometimes for the treatment of hyperplasia is enough to make a correction.
diet and fill the lack of iodine. To do this, appoint
supplemental food with high iodine content
(fish, fruits and vegetables, especially those growing on the sea
Гиперплазия thyroid gland – доброкачественный процесс. The
However, as hyperplasia progresses, deficiency develops.
hormone T4, which negatively affects the work of the heart and can become
cause of death.
The results of treatment vary depending on the main
заболевания, ставшего причиной hyperplasia. In the early stages
Development prognosis remains favorable. Size reduction or
full recovery after hormone replacement therapy
celebrated within 3-6 months.
При узловой форме признаки гиперплазии thyroid gland
полностью исчезают only у 1/3 пациентов, получающих
replacement therapy. Effective method at this stage
is a surgical intervention. However, even при
adequate response to hormone therapy, repeated episode may
be observed in a few years or even months.
Гиперплазия, причиной которой является рак thyroid gland,
has a poor prognosis and lack of effectiveness
diagnostic and therapeutic interventions can lead to death
Автор: TOоробов Никита Александрович врач-анестезиолог