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Thyrotoxicosis

German: Thyreotoxikose

1 Definition

The term thyrotoxicosis denotes excessive supply of the organism with thyroid hormones.

2 Classification

Thyrotoxicosis is a general term. True hyperthyroidism by exceeding function of the thyroid gland is used to be distinguished from factititious thyrotoxicosis by exogenously supplied thyroxine, e. g. by misdosage (Thyreotoxicosis factitia)[1].

As a rule of thumb, all forms of thyrotoxicosis caused by increased activity of thyroid peroxidase are referred to as hyperthyroidism. Other forms of thyrotoxicosis include increased release of preformed thyroid hormones in thyroiditis and excessive intake of exogenous thyroid hormone.

HyperthyrodismNon-hyperthyroid thyrotoxicosis
 Primary hyperthyroidism

  Graves' disease
  Toxic multinodular goiter
  Toxic adenoma
  Iodine excess
   AIT type 1
  Struma ovarii
  Metastatic differentiated thyroid cancer
 Secondary hyperthyroidism
  TSH-secreting adenoma
  HCG-mediated hyperthyroidism

 Factitious thyrotoxicosis

  L-T4
  L-T3
  L-T4/L-T3 combination therapy
  TRIAC
  Desiccated thyroid
  Dietary supplements
  Improperly processed meat
 Inflammatory thyrotoxicosis
  Subacute thyroiditis
  Acute thyroiditis
  AIT type 2

3 Grading

Severity as well as probability of thyrotoxicosis can clinically be assessed by means of the Burch-Wartofsky-Score.

The following scale is apt to estimate the severity of thyrotoxicosis alone:

StadiumSymptoms
  Stadium I   Agitation, Hyperthermia, Tachycardia*
  Stadium II  Impaired consciousness, Hallucinations
  Stadium III  Coma

* > 150/min. True hyperthyroidism by exceeding function of the thyroid gland is used to be distinguished from thyrotoxicosis by exogenously supplied thyroxine, e. g. by misdosage (Thyreotoxicosis factitia).#

4 References

  1. Fatourechi V. (2014) Hyperthyroidism and Thyrotoxicosis. In: Bandeira F., Gharib H., Golbert A., Griz L., Faria M. (eds) Endocrinology and Diabetes. Springer, New York, NY. DOI 10.1007/978-1-4614-8684-8_2

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