Hyperthyroidism

Hyperthyroidism occurs at all ages but is less common under the age of 15. It is 10 times more common in women than in men, with an annual incidence of about 1 per 1000 women.2 Causes of hyperthyroidism are shown in .T.a.ble..„2.,0.6-1.. Graves disease is by far the most common cause, accounting for more than 80 percent of cases of hyperthyroidism in the United States.3 Toxic multinodular and toxic (adenoma) nodular goiters are the next most frequent causes. Graves' disease is common in the third and fourth decades of life. It is characterized by hyperthyroidism due to an autoimmune activation of TSH, diffuse goiter, ophthalmopathy, and dermopathy. In contrast, toxic multinodular goiter usually occurs in a somewhat older population, commonly with a previous history of simple goiter. 2 Often, these patients have milder symptoms of thyrotoxicosis. Less common causes of hyperthyroidism are thyroiditis, pituitary tumors, metastatic thyroid cancer, and dermoid tumors or teratomas of the ovary. Medication-induced hyperthyroidism may be due to iodine ingestion, lithium therapy, or thyroid medication (thyrotoxicosis facticia). Amiodarone-induced thyrotoxicosis has been reported to be between 1 and 23 percent.4

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