Plummer’s disease is a group of endocrine pathologies. This disease is characterized by the formation of a benign tumor in the thyroid gland, which intensively produces thyroid hormones. From a clinical point of view, this pathological process is characterized by signs indicating the development of thyrotoxicosis. In the event that such a condition was diagnosed on time, it does not pose a serious threat to the sick person. In the opposite situation, there is a risk of malignant tumor degeneration. Another possible complication is autoimmune thyreopathy.
The disease got its name in honor of the scientist Henry Stanley Plummer, who described it for the first time in nineteen thirteen years. There is another name – thyrotoxic adenoma. It is noticed that female representatives are almost four times more likely than men to face this pathological process. In the childhood and adolescent age groups, such a pathology is rare, but isolated cases do occur. As for the malignant degeneration of an arisen tumor, this complication is detected in about three percent of cases. If we consider Plummer’s disease in terms of the likelihood of autoimmune thyreopathy, this is about four percent.
Currently, the question of why this pathological process develops is still open. Most scientists agree that genetic mutations that lead to changes in the morphological characteristics of thyroid cells underlie the emergence of thyrotoxic adenoma. Presumably, various external influences can lead to such mutations, for example, chronic intoxication of the body or prolonged contact with radiation. It is also noted that a significantly larger number of cases diseases Plummer is registered in regions suffering from iodine deficiency. Other predisposing factors include past traumatic effects on the thyroid gland, hereditary aggravation, existing endocrine and autoimmune pathologies.
As we have said, the resulting tumor actively produces thyroid hormones. At the same time, signs of thyrotoxicosis in Plummer’s disease are predominantly increasing due to an increase in the level of triiodothyronine. Thyroid-stimulating hormone, which is produced in the pituitary gland and has a regulating effect on the synthesis of thyroid hormones, while remaining within normal limits or decreases moderately. In the case of a prolonged course of this pathological process, a marked inhibition of the production of thyroid-stimulating hormone is noted.
If we consider an emerging neoplasm from a morphological point of view, then we can say that it is represented by a microfollicular structure. However, sometimes with certain conditions, macrofollicular tumors can also be detected. A palpable examination of Plummer’s disease reveals a rounded densely elastic node that can be of various sizes. Important features of this site are clear contours and lack of pain. In addition, you can see that during swallowing, it shifts along with the thyroid gland.
Symptoms characteristic of Plummer’s disease
Depending on the accompanying clinical picture, this disease can be compensated and decompensated. With the compensated version of the flow, if any manifestations are expressed, then very little. Decompensated version is characterized by extremely intense symptoms.
First of all, a sick person indicates that there are problems with the cardiovascular system. From a clinical point of view, this is manifested by pain and heaviness in the chest, palpitations, and shortness of breath. With a severe course of the pathological process, shortness of breath becomes extremely pronounced and is complemented by bouts of dizziness. When examination is detected tachycardia.
There are mandatory symptoms such as decreased muscle tone and muscle pain. Due to the changes taking place, the patient cannot perform his usual work and gets tired quickly. Another characteristic point is a violation of the emotional background. A sick person becomes emotionally labile, often breaks out for no reason, cries and indicates causeless anxiety. There are difficulties when trying to concentrate on something, it becomes faster, and movements are chaotic. Often there are problems with falling asleep.
In addition, symptoms such as increased appetite with parallel weight loss, excessive sweating, poor heat tolerance, and problems with the reproductive system are characteristic. Men begin to experience difficulties with potency, and women complain of irregularities in the menstrual cycle. In some cases, you can detect a constant increase in body temperature to subfebrile values, but this point is not mandatory.
Diagnosis and treatment of Plummer’s disease
Thyrotoxic adenoma is diagnosed by thorough physical examination combined with additional methods. A mandatory ultrasound examination is performed on the patient. Also highly informative is radionuclide diagnostics. Additionally, it is necessary to assess the level of thyroid hormones, as well as TSH.
Treatment of this disease can be carried out using both conservative and surgical methods. Of the drugs used thyreostatics. However, they are effective only with small tumor sizes, as well as in the absence of its growth. Otherwise, surgical intervention is necessary.
Prevention of the development of thyrotoxic adenoma
For prophylaxis the occurrence of this pathological process is recommended to monitor the sufficient intake of iodine in the body, as well as to avoid chronic intoxication or long-term exposure.