II. Epidemiology

  1. Toxic Multinodular Goiter is second most common cause of Hyperthyroidism in U.S. (5% of cases)

III. Risk Factors

  1. Diets deficient in Iodine (esp. elderly)

IV. Causes

  1. Simple Goiter develops into Multinodular Goiter

V. Types

  1. Non-Toxic Multinodular Goiter
  2. Toxic Multinodular Goiter (50%)
    1. Increase in clonogenic cells with TSH receptor mutation (somatic activating)
    2. Results in Thyrotoxicosis

VI. Differential Diagnosis

VII. Symptoms

  1. Dysphagia
  2. Choking sensation

VIII. Signs

  1. Markedly enlarged nodular Thyroid
  2. Stridor

IX. Complications

  1. Toxic Multinodular Goiter (Thyrotoxicosis)
    1. Cardiovascular complications
      1. Atrial Fibrillation
      2. Tachycardia
      3. Congestive Heart Failure
    2. No Ophthalmopathy (Proptosis and stare)
    3. No Dermopathy
  2. Both Toxic and Non-Toxic Multinodular Goiter
    1. Superior Vena Cava Syndrome
      1. Results from thoracic outlet obstruction

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Ontology: Toxic multinodular goiter (C0154143)

Concepts Disease or Syndrome (T047)
ICD9 242.2
ICD10 E05.2
SnomedCT 190249001, 154658002, 26389007
English Thyrotox + tox multinod goiter, Thyrotox + tox multinod goitre, Thyrotoxic - multinodul goiter, Thyrotoxic - multinodul goitre, Toxic multinodular goiter NOS, Toxic multinodular goitre NOS, toxic multinodular goiter, toxic multinodular goiter (diagnosis), parry disease, multinodular toxic goiter, Goitre;multinodular;toxic, multinodular toxic goitre, Toxic multinodular goitre (disorder), Toxic multinodular goiter NOS (disorder), Toxic multinodular goiter, Secondary thyroid hyperplasia, Thyrotoxicosis due to multinodular goiter, Thyrotoxicosis due to multinodular goitre, Thyrotoxicosis with toxic multinodular goiter, Thyrotoxicosis with toxic multinodular goitre, Toxic multinodular goitre, Toxic multinodular goiter (disorder), Parry, goiter; thyrotoxicosis, multinodular, multinodular; goiter, toxic or with hyperthyroidism, nodular; goiter, with thyrotoxicosis, struma; multinodular, toxic or with hyperthyroidism, struma; nodular, with thyrotoxicosis, struma; thyrotoxicosis, nodular, struma; toxic, multinodular, thyrotoxicosis; goiter, multinodular, thyrotoxicosis; goiter, nodular, toxic; goiter, multinodular, Goiter;multinodular;toxic, toxic multinodular goitre
Dutch toxisch multinodulair struma, multinodulair; struma, toxisch of met hyperthyroïdie, nodulair; struma, met thyrotoxicose, struma; multinodulair, toxisch of met hyperthyroïdie, struma; nodulair, met thyrotoxicose, struma; thyrotoxicose, multinodulair, struma; thyrotoxicose, nodulair, struma; toxisch, multinodulair, thyrotoxicose; struma, multinodulair, thyrotoxicose; struma, nodulair, toxisch; struma, multinodulair, Thyrotoxicose met toxische multinodulaire struma
French Goitre multinodulaire toxique
German toxische multi-nodulaere Struma, Hyperthyreose mit toxischer mehrknotiger Struma
Italian Gozzo multinodulare tossico
Portuguese Bócio multinodular tóxico
Spanish Bocio multinodular tóxico, bocio tóxico multinodular, SAI (trastorno), bocio tóxico multinodular, SAI, bocio multinodular tóxico (trastorno), bocio multinodular tóxico, hiperplasia tiroidea secundaria
Japanese チュウドクセイタケッセツセイコウジョウセンシュ, 中毒性多結節性甲状腺腫
Czech Toxická mnohouzlová struma
Korean 중독성 다결절성 갑상샘종을 동반한 갑상샘중독증
Hungarian Toxikus multinodularis struma

Ontology: Non-toxic multinodular goiter (C0271761)

Concepts Disease or Syndrome (T047)
ICD9 241.1
ICD10 E04.2
SnomedCT 154653006, 36241006
English Nontoxic multinodular goiter, Nontoxic multinodular goitre, nontoxic multinodular goiter (diagnosis), nontoxic multinodular goiter, Nontox multinodul goiter, Goitre;multinodular;non toxic, Non-toxic multinodular goitre (disorder), Multinodular non-toxic goiter, Non-toxic multinodular goiter, Multinodular non-toxic goitre, Non-toxic multinodular goitre, Non-toxic multinodular goiter (disorder), nontoxic; goiter, multinodular, struma; nontoxic, multinodular, Goiter;multinodular;non toxic, non toxic multinodular goiter, non toxic multinodular goitre
Dutch niet-toxische multinodulaire struma, niet-toxisch multinodulair struma, niet-toxisch; struma, multinodulair, struma; niet-toxisch, multinodulair, Niet-toxische multinodulaire struma
French Goitre multinodulaire non toxique
German nicht-toxische multi-nodulaere Struma, Nichttoxische mehrknotige Struma
Italian Gozzo multinodulare non tossico
Portuguese Bócio multinodular não tóxico
Spanish Bocio multinodular no tóxico, bocio multinodular no tóxico (trastorno), bocio multinodular no tóxico, bocio no tóxico multinodular
Japanese 非中毒性多結節性甲状腺腫, ヒチュウドクセイタケッセツセイコウジョウセンシュ
Czech Netoxická mnohouzlová struma
Korean 비중독성 다결절성 갑상샘종
Hungarian Nem-toxikus multinodularis struma

Ontology: Multinodular goiter (C0342208)

Concepts Disease or Syndrome (T047)
SnomedCT 237570007
English the thyroid had multiple nodules, Multinodular goiter, multiple nodules of thyroid, multiple nodules of thyroid (physical finding), multinodular goiter, multiple nodules thyroid, multinodular thyroid, goiters multinodular, multinodular goitre, thyroid multinodular, Multinodular goitre, Multiple thyroid nodules, Multinodular goiter (disorder), multinodular; goiter, struma; multinodular
Dutch multinodulair; struma, struma; multinodulair
Spanish bocio multinodular (trastorno), bocio multinodular, nódulos tiroideos múltiples