WordNet

an impairment of health or a condition of abnormal functioning
caused by or altered by or manifesting disease or pathology; "diseased tonsils"; "a morbid growth"; "pathologic tissue"; "pathological bodily processes" (同)morbid, pathologic, pathological

PrepTutorEJDIC

(体の)『病気』,疾患 / (精神・道徳などの)病気,病弊
女性の話術芸人 =diseur
病気にかかった / 病的な,不健全な(morbid)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/02/13 09:47:47」(JST)

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Toxic multinodular goiter (also known as toxic nodular goiter, toxic nodular struma) is a multinodular goiter associated with a hyperthyroidism.

It is a common cause of hyperthyroidism^[1]^[2] in which there is excess production of thyroid hormones from functionally autonomous thyroid nodules, which do not require stimulation from thyroid stimulating hormone (TSH).^[3]

It is the second most common cause of hyperthyroidism (after Graves' disease) in the developed world. In countries where the population is iodine-deficient i.e. the developing world, iodine deficiency is the most common cause of hypothyroidism. (Decreased iodine leads to decreased thyroid hormone.) However, iodine deficiency can cause goitre (thyroid enlargement); within a goitre, nodules can develop. Risk factors for toxic multinodular goiter include individuals over 60 years of age and being female.^[4]

Signs and symptoms

Symptoms of toxic multinodular goitre are similar to that of hyperthyroidism, including:^[4]

heat intolerance
muscle weakness/wasting
hyperactivity
fatigue
tremor
irritability
weight loss
osteoporosis
increased appetite
non-painful goitre (swelling of the thyroid gland)
tachycardia (high heart rate - above 100 beats per minute at rest in adults)

Causes

Sequence of events:^[5]

Iodine deficiency leading to decreased T4 production.
Induction of thyroid cell hyperplasia due to low levels of T4. This accounts for the multinodular goitre appearance.
Increased replication predisposes to a risk of mutation in the TSH receptor.
If the mutated TSH receptor is constitutively active, it would then become 'toxic' and produces excess T3/T4 leading to hyperthyroidism.

Treatments

Toxic multinodular goiter can be treated with antithyroid medications such as propylthiouracil or methimazole, radioactive iodine, or with surgery.^[4]

Another treatment option is injection of ethanol into the nodules.^[6]

Related eponym

Plummer's disease is named after the American physician Henry Stanley Plummer but refers to a single toxic nodule (adenoma) which may present with the background of a suppressed multinodular goitre.^[7]

References

^ de Rooij, A; Vandenbroucke, JP; Smit, JW; Stokkel, MP; Dekkers, OM (2009). "Clinical outcomes after estimated versus calculated activity of radioiodine for the treatment of hyperthyroidism: systematic review and meta-analysis.journal=European journal of endocrinology" 161 (5). pp. 771–777. doi:10.1530/EJE-09-0286. PMID 19671708.
^ Krohn, K; Fuhrer, D; Bayer, Y; Eszlinger, M; Brauer, V; Neumann, S; Paschke, R (2005). "Molecular pathogenesis of euthyroid and toxic multinodular goiter.". Endocrine reviews 26 (4): 504–524. doi:10.1210/er.2004-0005. PMID 15615818.
^ Reid, JR; Wheeler, SF (2005). "Hyperthyroidism: diagnosis and treatment.". American family physician 72 (4): 623–630. PMID 16127951.
^ ^a ^b ^c A.D.A.M. Medical Encyclopedia (2012). "Toxic nodular goiter". U.S. National Library of Medicine. Retrieved 30 January 2013.
^ http://emedicine.medscape.com/article/120497-overview
^ al.], senior editors, J. Larry Jameson, Leslie J. De Groot ; section editors, David de Kretser ... [et (2010). Endocrinology : adult and pediatric (6th ed. ed.). Philadelphia: Saunders/Elsevier. p. Chapter 82. ISBN 9781416055839.
^ Plummer's disease eponymously named after Henry Stanley Plummer at Who Named It?

External links

UpToDate Contents

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1. 中毒性腺腫および中毒性多結節性甲状腺腫の治療 treatment of toxic adenoma and toxic multinodular goiter
2. 甲状腺結節の診断的アプローチおよび治療 diagnostic approach to and treatment of thyroid nodules
3. 放射性ヨウ素による甲状腺機能亢進症の治療 radioiodine in the treatment of hyperthyroidism
4. 甲状腺機能亢進症の診断 diagnosis of hyperthyroidism
5. 食道輪および食道ウェブ esophageal rings and webs

English Journal

An Ex Vivo Model for Suture-Less Amniotic Membrane Transplantation with a Chemically Defined Bioadhesive.

Tsujita H, Brennan AB, Plummer CE, Nakajima N, Hyon SH, Barrie KP, Sapp B, Jackson D, Brooks DE.SourceDepartment of Small and Large Animal Sciences, Comparative Ophthalmology Service, College of Veterinary Medicine, University of Florida , 2015 SW 16th Avenue, Gainesville, FL , USA.
Current eye research.Curr Eye Res.2012 Mar 29. [Epub ahead of print]
Purpose: Chemically defined bioadhesives (CDB) are "two-component reactive adhesives" made from antibiotic food additives. They contain no animal-derived ingredients and are characterized by a high level of self-degradability, low toxicity, and strong bonding properties. Amniotic membrane (AM) trans
PMID 22458783

Patient selection for oncology phase I trials: a multi-institutional study of prognostic factors.

Olmos D, A'hern RP, Marsoni S, Morales R, Gomez-Roca C, Verweij J, Voest EE, Schöffski P, Ang JE, Penel N, Schellens JH, Del Conte G, Brunetto AT, Evans TR, Wilson R, Gallerani E, Plummer R, Tabernero J, Soria JC, Kaye SB.SourceBSc, Royal Marsden Hospital and Institute of Cancer Research, Sycamore House, Downs Rd, Sutton, United Kingdom SM2 5PT; stan.kaye@rmh.nhs.uk.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology.J Clin Oncol.2012 Mar 20;30(9):996-1004. Epub 2012 Feb 21.
PURPOSE The appropriate selection of patients for early clinical trials presents a major challenge. Previous analyses focusing on this problem were limited by small size and by interpractice heterogeneity. This study aims to define prognostic factors to guide risk-benefit assessments by using a larg
PMID 22355064

Japanese Journal

健診時に見出される甲状腺中毒症の特徴

中村保子,森村匡志
人間ドック 26(3), 467-473, 2011-09
NAID 40019017712

Intra-thyroid blood flow in Plummer's disease.

Kurita Seiichiro,Ando Hitoshi,Kaneko Shuichi,Takamura Toshinari
Internal Medicine 47(11), 1065-1066, 2008
NAID 130000078670

「プランマー病」

Toxic multinodular goiter
Classification and external resources
ICD-10	E05.2
ICD-9	242.3
DiseasesDB	13184
MedlinePlus	000317
eMedicine	med/920

　　[★]

英: Plummer disease
同: 結節性甲状腺中毒症 toxic adenomatous goiter
関: 機能性甲状腺結節、甲状腺腫、甲状腺機能亢進症

概念

甲状腺刺激ホルモン TSH非依存性に、ホルモンを自律性に産生する甲状腺の結節性病変に甲状腺中毒症状を伴う病態。
結節性、単発性、被膜有、辺縁平滑な甲状腺腺腫が甲状腺ホルモンを過剰に産生する病態 (SRA.195)
文献によっては腺腫様甲状腺腫(結節性多発性、辺縁不明瞭、被膜無し)が甲状腺ホルモンを過剰に産生する病態を含めるとしている。　→　中毒性多結節性甲状腺腫, 中毒性多発性甲状腺腫, AFTN

「disease」

　　[★]

n.

疾患：illnessより厳密な概念。「ある臓器に明確な障害が確認され、それによって症状が出ているとはっきり説明できる場合」 (PSY.9)

特定の原因、病態生理、症状、経過、予後、病理組織所見が全てそろった場合 (PSY.9)

something that is very wrong with people's attitudes, way of life or with society.

関: ail、ailment、disease entity、disorder、ill、illness、malady、sick、sickness

注意

disease ≠ illness ≠ disorder

[Europe-1] Rooij, A; Vandenbroucke, JP; Smit, JW; Stokkel, MP; Dekkers, OM (2009). "Clinical outcomes after estimated versus calculated activity of radioiodine for the treatment of hyperthyroidism: systematic review and meta-analysis.journal=European journal of endocrinology" 161 (5). pp. 771–777. doi:10.1530/EJE-09-0286. PMID 19671708.

[endocrine-2] Krohn, K; Fuhrer, D; Bayer, Y; Eszlinger, M; Brauer, V; Neumann, S; Paschke, R (2005). "Molecular pathogenesis of euthyroid and toxic multinodular goiter.". Endocrine reviews 26 (4): 504–524. doi:10.1210/er.2004-0005. PMID 15615818.

[family-3] Reid, JR; Wheeler, SF (2005). "Hyperthyroidism: diagnosis and treatment.". American family physician 72 (4): 623–630. PMID 16127951.

[Adam-4] A.D.A.M. Medical Encyclopedia (2012). "Toxic nodular goiter". U.S. National Library of Medicine. Retrieved 30 January 2013.

[5] ttp://emedicine.medscape.com/article/120497-overview

[6] .], senior editors, J. Larry Jameson, Leslie J. De Groot ; section editors, David de Kretser ... [et (2010). Endocrinology : adult and pediatric (6th ed. ed.). Philadelphia: Saunders/Elsevier. p. Chapter 82. ISBN 9781416055839.

[7] Plummer's disease eponymously named after Henry Stanley Plummer at Who Named It?

匿名

検索

案内

案内

Plummer disease