Goiter causes
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Reddy Kothagadi M.B.B.S[2]
Overview
Various factors have been associated with the cause of goiter such as hereditary, hormonal, dietary, pharmacological, physiological, environmental and pathological factors. The most common causes being, iodine deficiency, Grave’s disease and hashimoto’s disease. Goiter may be caused by a mutation in the genes such as the thyroglobulin (Tg) gene, thyroid-stimulating hormone receptor (TSHR) gene and the sodium-iodide symporter (NIS) gene.
Causes
Factors associated with goiter can be classified as follows:
Hereditary factors
- Inherited defect(Familial goiter) of thyroid hormone synthesis such as:
- Enzymatic defect deficiency
- Dyshormonogenesis
Hormonal factors
Thyroid hormone dysfunction:
- Hyperthyroidism (overproduction of thyroid hormones)
- Hypothyroidism (underproduction of thyroid hormones)
Dietary factors
- Dietary iodine deficiency
- Goitrogens (play a major role in endemic goitre)
Pharmacological factors
- Use of goitrogenic drugs like para-aminosalicylic acid (PAS), thiocyanate and antithyroid drugs [e.g. thiouracil, carbimazole] results in hypothyroidism
Physiological factors
- Increased metabolic demand of thyroid hormones e.g. during pregnancy or puberty results in physiological goiter.
Environmental factors
- Exposure to radiations leading to:
Pathological factors
Intrinsic thyroid gland diseases:
- Inflammatory goitres
- Neoplastic goitres
- Benign adenoma (follicular adenoma)
- Malignant
- Primary: Well differentiated, poorly differentiated, arising from parafollicular cells
- Secondary
Common Causes
Goiter may be caused by:
Less Common Causes
Less common causes of Goiter include:
Genetic Causes
- Goiter may be caused by a mutation in the following genes which vary from one family to the other: [1]
- Multinodular goiter marker 1 (MNG1) on chromosome 14 [1]
References
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