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Management – Surgery or radiation for tumor removal

Myxedema (acquired hypothyrotidism) When hypothyroidism occurs in older children or adults it is called myxedema. The term myxedema caused by an accumulation of a hydrophilic mucopoly saccharde substance in the connective tissues throughout the body. The hypothyroid state may be mild, with only a few signs and symptoms, or it may progress to a life-threatening condition or dysfunction of the thyroid gland (primary hypothyroidism) or as a secondary disorder caused by impaired hypothalamic or pituitary function. Primary hypothyroidism may result from thyrodiectomy (surgical removal) or ablation of the gland with radiation. Certain goitrogenic agents, such as lithium carbonate (used in the treatment of manic-depressive states) and the antithyroid drugs propylthiouracil and methimazole in continuous dosage, can block hormone synthesis and produce hypothyroidism Pathophysiology 174 with goiter. Large amounts of iodine can also block thyroid hormone production and cause goiter, particularly in persons with autoimmune thyroid disease. Probably the most common cause of hypothyroidism is Hashimato’s thyroiditis, an autoimmune disorder in which the thyroid gland may be totally destroyed by an immunologic process. It is the major cause goiter and hypothyroidism in children. Hashimato’s thyroiditis is predominantly a disease of women. The course of the disease varies. At the onset only a goiter may be present. In time, hyprothyroidism usually become evident. Although the disorder generally causes hypothyroidism, a hyperthyroid state may develop mid course in the disease. The transient hyperthyroid state is due to leakage of performed thyroid hormone from damaged cells of the gland.