II. Epidemiology

  1. Endemic in areas distant from sea (e.g. mountains)
    1. Common sites: Alps, Andes, and Himalayas
    2. Related to deficient Iodine intake
    3. Often occurs before Puberty
  2. Sporadic form much more common in women (8:1)
    1. Adolescent girls
    2. Pregnant, Lactating or Menopausal women

III. Criteria

  1. Diffuse Thyroid enlargement without nodularity
  2. Euthyroid function

IV. Causes

  1. Idiopathic (Sporadic)
  2. Iodine Deficiency (Endemic Goiter)
  3. Goitrogens (Thyroid suppressants)
    1. Calcium and fluorides in water
    2. Cabbage
    3. Cassava
    4. Cauliflower
    5. Brussels sprouts
    6. Turnips

V. Symptoms

  1. Often asymptomatic
  2. Thyroid sensitive to touch
  3. Dyspnea
  4. Dysphagia
  5. Cough with large glands

VI. Signs

  1. Palpable diffuse Thyroid enlargement
  2. No Thyroid nodularity

VII. Management

  1. Early Goiter
    1. Iodine replacement results in Goiter regression
  2. Late Goiter
    1. Thyroid Replacement required

VIII. Prevention

  1. Iodized Salt in diet

IX. Course

  1. If untreated, develops into Multinodular Goiter

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Related Studies

Ontology: Goiter (C0018021)

Definition (NCI) Enlargement of the thyroid gland usually caused by lack of iodine in the diet, hyperthyroidism, or thyroid nodules. Symptoms include difficulty in breathing and swallowing.
Definition (NCI_NCI-GLOSS) An enlarged thyroid. It may be caused by too little iodine in the diet or by other conditions. Most goiters are not cancer.
Definition (MSH) Enlargement of the THYROID GLAND that may increase from about 20 grams to hundreds of grams in human adults. Goiter is observed in individuals with normal thyroid function (euthyroidism), thyroid deficiency (HYPOTHYROIDISM), or hormone overproduction (HYPERTHYROIDISM). Goiter may be congenital or acquired, sporadic or endemic (GOITER, ENDEMIC).
Definition (CSP) enlargement of the thyroid gland.
Concepts Disease or Syndrome (T047)
MSH D006042
ICD9 240.9
ICD10 E04.9
SnomedCT 190235005, 267370001, 237568003, 190232008, 313001000009108, 3716002
French GOITRE, Goitre, non précisé, Hypertrophie thyroïdienne, Goitre non précisé, Thyromégalie, AUGMENTATION VOLUME THYROIDE, Goitre
English GOITER, GOITRE, THYROID ENLARGED, Goiter, unspecified, Goitre NOS, enlargement under Adam's apple (symptom), enlargement under Adam's apple, goiter, Goiter, Enlarged thyroid, Thyroid enlarged, Goitre, unspecified, Goiter NOS, Goiter [Disease/Finding], enlargement of thyroid, swelling thyroid gland, Enlarged;thyroid, Enlargement;thyroid, enlarged thyroid, goiter thyroid, thyroid goiter, Struma, enlarged thyroid gland, goitres, goiters, thyroid gland swelling, thyromegaly, Goiter NOS (disorder), Goitre (disorder), Enlarged thyroid gland, Enlarged thyroid gland (finding), Thyromegaly, Enlargement of thyroid, Struma of thyroid, Goitre, Struma - goiter, Struma - goitre, Swelling of thyroid gland, Thyroid enlargement, Goiter (disorder), enlargement; thyroid, struma, thyroid; enlargement, Goiter, NOS, Goitre, NOS, Goiters, goitre, thyroid enlargement
Portuguese BOCIO, Bócio NE, Tiroideia aumentada de volume, Tiromegalia, AUMENTO DE VOLUME DA TIROIDE, Bócio
Spanish BOCIO, Bocio no especificado, Tiromegalia, Hipertrofia del tiroides, Tiroides agrandado, TIROIDES AUMENTADO, bocio, SAI, bocio, SAI (trastorno), agrandamiento de la tiroides, bocio (trastorno), bocio, estruma tiroideo, Bocio
German STRUMA, Struma, unspezifisch, vergroesserte Schilddruese, Schilddruesenvergroesserung, Schilddruese vergroessert, SCHILDDRUESENVERGROESSERG, Kropf, Struma
Dutch struma, niet-gespecificeerd, thyromegaly, vergroot thyroïd, vergrote schildklier, schildklier; vergroting, vergroting; schildklier, struma, Goitre, Krop, Struma
Italian Gozzo non specificato, Tiroide ingrandita, Tiromegalia, Gozzo
Japanese 甲状腺腫、詳細不明, 甲状腺腫大, 甲状腺腫, コウジョウセンシュショウサイフメイ, コウジョウセンシュダイ, コウジョウセンシュ
Swedish Struma
Czech struma, Struma, blíže neurčená, Zvětšená štítná žláza, Tyromegalie, Struma
Finnish Struuma
Russian ZOB, ЗОБ
Croatian STRUMA
Polish Wole
Hungarian Struma, Struma, nem meghatározott, Pajzsmirigy megnagyobbodása, Pajzsmirigy-megnagyobbodás, Megnagyobbodott pajzsmirigy
Norwegian Struma

Ontology: Endemic goiter (C0018022)

Definition (NCI) Thyroid gland enlargement caused by inadequate dietary iodine intake. It occurs in areas in which the soil lacks iodine compounds or there is low seafood consumption.
Definition (MSH) A form of IODINE deficiency disorders characterized by an enlargement of the THYROID GLAND in a significantly large fraction of a POPULATION GROUP. Endemic goiter is common in mountainous and iodine-deficient areas of the world where the DIET contains insufficient amount of iodine.
Concepts Disease or Syndrome (T047)
MSH D006043
ICD9 240.0
ICD10 E01.2 , E01.0
SnomedCT 190316007, 191043000, 190319000, 190234009, 56805008, 267369002, 271949009
English Endemic Goiters, Goiter, Endemic, Goiters, Endemic, Goiter, specified as simple, Endemic goiter, Endemic goiter - iodine defic, Endemic goitre - iodine defic, Iod-def-rel (endm) goit,uns, Iod-def-reltd df(endemic)goitr, Iodine-deficiency-related (endemic) goiter, unspecified, Iodine-deficiency-related (endemic) goitre, unspecified, [X]Iod-def-rel (endm) goit,uns, [X]Iodine-deficiency-related (endemic) goiter, unspecified, [X]Iodine-deficiency-related (endemic) goitre, unspecified, simple goiter (diagnosis), iodine deficient endemic goiter, iodine deficient endemic goiter (diagnosis), simple goiter, Goitre, specified as simple, Endemic goiter NOS, Iodine-deficiency related diffuse (endemic) goiter, Iodine-deficiency related (endemic) goiter, unspecified, Goiter, Endemic [Disease/Finding], endemic goiter, goiters iodine, iodine goiter, endemic goitre, [X]Iodine-deficiency-related (endemic) goiter, unspecified (disorder), [X]Iodine-deficiency-related (endemic) goitre, unspecified (disorder), Iodine-deficiency-related endemic goitre (disorder), Simple goiter, Simple iodine deficiency goiter, Endemic goitre, Iodine-deficiency-related diffuse (endemic) goiter, Iodine-deficiency-related diffuse (endemic) goitre, Simple goitre, Simple iodine deficiency goitre, Iodine-deficiency-related endemic goiter, Iodine-deficiency-related endemic goitre, Endemic goiter (disorder), Iodine-deficiency-related endemic goiter (disorder), Simple goiter (disorder), endemic; goiter, iodine-deficiency; goiter (endemic), simple; goiter, struma; endemic, struma; iodine-deficiency (endemic), struma; simple, Simple Goiter, Endemic Goiter
Dutch struma, gespecificeerd als enkelvoudig, enkelvoudige struma, endemisch struma, endemisch; struma, jodiumdeficiëntie; struma (endemisch), simplex; struma, struma; endemisch, struma; jodiumdeficiëntie (endemisch), struma; simplex, Diffuse (endemische) struma samenhangend met jodiumdeficiëntie, Struma (endemisch) samenhangend met jodiumdeficiëntie, niet gespecificeerd, Endemische struma, Struma, endemisch
French Goitre, précisé simple, Goitre simple, Goitre myxoedémateux, Goitre endémique
German Struma, als einfach bezeichnet, einfache Struma, Jodmangelbedingte Struma (endemisch), nicht naeher bezeichnet, Jodmangelbedingte diffuse Struma (endemisch), endemischer Kropf, Struma, endemische
Italian Gozzo specificato come semplice, Gozzo semplice, Gozzo endemico
Portuguese Bócio especificado como simples, Bócio simples, Bócio endémico, Bócio Endêmico
Spanish Bocio especificado como simple, Bocio simple, Bocio endémico, [X]bocio relacionado con la deficiencia de iodo (endémico), no especificado, [X]bocio relacionado con la deficiencia de yodo (endémico), no especificado, [X]bocio relacionado con la deficiencia de yodo (endémico), no especificado (trastorno), bocio endémico (trastorno), bocio endémico relacionado con deficiencia de yodo (trastorno), bocio endémico relacionado con deficiencia de yodo, bocio endémico, bocio simple (trastorno), bocio simple por deficiencia de yodo, bocio simple, Bocio Endémico
Japanese 単純性甲状腺腫, タンジュンセイコウジョウセンシュ, 甲状腺腫-地方病性, チホウビョウセイコウジョウセンシュ, 地方性甲状腺腫, 地方病性甲状腺腫
Swedish Struma, endemisk
Czech struma endemická, Struma, určená jako prostá, Prostá struma, Endemická struma
Finnish Endeeminen struuma
Korean 요오드결핍과 관련된 미만성(풍토성) 갑상샘종, 요오드결핍과 관련된(풍토성) 상세불명의 갑상샘종
Polish Wole endemiczne
Hungarian Struma, egyszerűnek meghatározott, Endemiás struma, Egyszerű struma
Norwegian Endemisk struma, Struma, endemisk

Ontology: Colloid goiter (C0221268)

Concepts Disease or Syndrome (T047)
ICD10 E04.0
SnomedCT 190234009, 61037007
English Non-tox diffus colloid goiter, Non-tox diffus colloid goitre, Diffuse (colloid) nontoxic goiter, colloid goitre, colloid goiter, goiter colloid, Colloid goiter, Colloid goitre, Non-toxic diffuse colloid goiter, Non-toxic diffuse colloid goitre, Non-toxic colloid goiter, Non-toxic colloid goitre, Colloid goiter (disorder), nontoxic; goiter, diffuse (colloid), struma; nontoxic, diffuse (colloid)
Dutch niet-toxisch; struma, diffuus (colloïd), struma; niet-toxisch, diffuus (colloïd)
Spanish bocio coloide (trastorno), bocio coloide