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==Epidemiology and Demographics==
==Epidemiology and Demographics==
The epidemiology and demographics of toxic multinodular goiter is as below:<ref name="pmid9534034">{{cite journal| author=Siegel RD, Lee SL| title=Toxic nodular goiter. Toxic adenoma and toxic multinodular goiter. | journal=Endocrinol Metab Clin North Am | year= 1998 | volume= 27 | issue= 1 | pages= 151-68 | pmid=9534034 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9534034  }}</ref><ref name="pmid9267482">{{cite journal| author=Pelizzo MR, Bernante P, Toniato A, Fassina A| title=Frequency of thyroid carcinoma in a recent series of 539 consecutive thyroidectomies for multinodular goiter. | journal=Tumori | year= 1997 | volume= 83 | issue= 3 | pages= 653-5 | pmid=9267482 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9267482  }}</ref><ref name="pmid9019982">{{cite journal |vauthors=Pinchera A, Aghini-Lombardi F, Antonangeli L, Vitti P |title=[Multinodular goiter. Epidemiology and prevention] |language=Italian |journal=Ann Ital Chir |volume=67 |issue=3 |pages=317–25 |year=1996 |pmid=9019982 |doi= |url=}}</ref><ref name="pmid10487707">{{cite journal |vauthors=Gabriel EM, Bergert ER, Grant CS, van Heerden JA, Thompson GB, Morris JC |title=Germline polymorphism of codon 727 of human thyroid-stimulating hormone receptor is associated with toxic multinodular goiter |journal=J. Clin. Endocrinol. Metab. |volume=84 |issue=9 |pages=3328–35 |year=1999 |pmid=10487707 |doi=10.1210/jcem.84.9.5966 |url=}}</ref><ref name="pmid12762632">{{cite journal |vauthors=Tonacchera M, Vitti P, De Servi M, Agretti P, De Marco G, Chiovato L, Pinchera A |title=Gain of function TSH receptor mutations and iodine deficiency: implications in iodine prophylaxis |journal=J. Endocrinol. Invest. |volume=26 |issue=2 Suppl |pages=2–6 |year=2003 |pmid=12762632 |doi= |url=}}</ref>
===Incidence===
===Incidence===
*The incidence of solitary toxic adenomas was 4.8 per 100,000 population per year.<ref name="pmid9534034">{{cite journal| author=Siegel RD, Lee SL| title=Toxic nodular goiter. Toxic adenoma and toxic multinodular goiter. | journal=Endocrinol Metab Clin North Am | year= 1998 | volume= 27 | issue= 1 | pages= 151-68 | pmid=9534034 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9534034  }}</ref>
*The incidence of toxic multinodular goiter is estimated to be 4.8 cases per 100,000 population per year.
*The incidence of toxic adenomas may be related to the degree of iodine sufficiency.  
*The incidence of toxic multinodular goiter may be related to the degree of iodine sufficiency.  
*Correction of mild iodine deficiency has beneficial effects on the incidence of hyperthyroidism The total incidence of hyperthyroidism declined steadily to reach 44% of the control level in 1988/89. This was due to a decrease mostly of toxic nodular goiter.
** Correction of mild iodine deficiency has beneficial effects on the incidence of hyperthyroidism.
** In 1988-89, the correction of mild iodine deficiency led to a steady decline in the total incidence to reach 44% of the control level.
** The decline in total incidence was attributed to a decrease in the incidence of toxic nodular goiter.


===Prevalence===
===Prevalence===
* the prevalence of toxic adenomas was 1.6% of 2846 thyrotoxic patients in a research done in Cleveland.
* The prevalence of hyperthyroidism is estimated to be 2000 cases per 100,000 population.
* Toxic multinodular goiter accounts for 5% of all patients with hyperthyroidism.
* The prevalence of toxic adenomas was 1.6% of 2846 thyrotoxic patients in a research done in Cleveland.
* The prevalence of toxic thyroid nodules was significantly higher in an iodine-deficient population when compared with an iodine-sufficient population.
* The prevalence of toxic thyroid nodules was significantly higher in an iodine-deficient population when compared with an iodine-sufficient population.
* In iodine deficient areas, such as some areas of Italy (Pescopagano, in southern Italy), nodular goiter is present in 25-33% of the population.


===Case-fatality rate===
===Age==
===Age===
* Toxic multinodular goiter commonly affects individuals older than 60 years of age.
*The incidence of [disease name] increases with age; the median age at diagnosis is [#] years. [Disease name] commonly affects individuals younger than/older than [number of years] years of age.
* Hyperthyroidism associated with an autonomous nodule occurred in 57% of patients aged more than 60 years, whereas 13% of those younger than 60 years were hyperthyroid.
*Thyrotoxicosis associated with an autonomous nodule occurred in 57% of patients aged more than 60 years, whereas 13% of those younger than 60 years were hyperthyroid.
* Toxic multinodular goiter frequency increases with age.


===Race===
===Race===
Line 25: Line 31:
===Gender===
===Gender===
*[Gender 1] are more commonly affected by [disease name] than [gender 2]. The [gender 1] to [gender 2] ratio is approximately [number > 1] to 1.
*[Gender 1] are more commonly affected by [disease name] than [gender 2]. The [gender 1] to [gender 2] ratio is approximately [number > 1] to 1.
*was noted to be higher specifically in females aged 50 years or older.<ref name="pmid9267482">{{cite journal| author=Pelizzo MR, Bernante P, Toniato A, Fassina A| title=Frequency of thyroid carcinoma in a recent series of 539 consecutive thyroidectomies for multinodular goiter. | journal=Tumori | year= 1997 | volume= 83 | issue= 3 | pages= 653-5 | pmid=9267482 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9267482  }}</ref>
*was noted to be higher specifically in females aged 50 years or older.
*Toxic nodules were seen in women six times more than in men.
*Toxic nodules were seen in women six times more than in men.
*All benign thyroid disorders showed predominance in women.  Male/female ratio was 1/10 (10%) in the TMG group and 6/12 (50%) in the NMG group in our study.  We also found a significant difference in the incidence of malignancy in male patients between the two groups and the incidence of malignancy was found to be higher in the non-toxic male patients.
*All benign thyroid disorders showed predominance in women.  Male/female ratio was 1/10 (10%) in the TMG group and 6/12 (50%) in the NMG group in our study.  We also found a significant difference in the incidence of malignancy in male patients between the two groups and the incidence of malignancy was found to be higher in the non-toxic male patients.

Revision as of 18:22, 9 October 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Epidemiology and Demographics

The epidemiology and demographics of toxic multinodular goiter is as below:[1][2][3][4][5]

Incidence

  • The incidence of toxic multinodular goiter is estimated to be 4.8 cases per 100,000 population per year.
  • The incidence of toxic multinodular goiter may be related to the degree of iodine sufficiency.
    • Correction of mild iodine deficiency has beneficial effects on the incidence of hyperthyroidism.
    • In 1988-89, the correction of mild iodine deficiency led to a steady decline in the total incidence to reach 44% of the control level.
    • The decline in total incidence was attributed to a decrease in the incidence of toxic nodular goiter.

Prevalence

  • The prevalence of hyperthyroidism is estimated to be 2000 cases per 100,000 population.
  • Toxic multinodular goiter accounts for 5% of all patients with hyperthyroidism.
  • The prevalence of toxic adenomas was 1.6% of 2846 thyrotoxic patients in a research done in Cleveland.
  • The prevalence of toxic thyroid nodules was significantly higher in an iodine-deficient population when compared with an iodine-sufficient population.
  • In iodine deficient areas, such as some areas of Italy (Pescopagano, in southern Italy), nodular goiter is present in 25-33% of the population.

=Age

  • Toxic multinodular goiter commonly affects individuals older than 60 years of age.
  • Hyperthyroidism associated with an autonomous nodule occurred in 57% of patients aged more than 60 years, whereas 13% of those younger than 60 years were hyperthyroid.
  • Toxic multinodular goiter frequency increases with age.

Race

In a recent study, the incidence of malignancy in TMG was found to be 7% and most of them were papillary microcarcinomas.[6]

Gender

  • [Gender 1] are more commonly affected by [disease name] than [gender 2]. The [gender 1] to [gender 2] ratio is approximately [number > 1] to 1.
  • was noted to be higher specifically in females aged 50 years or older.
  • Toxic nodules were seen in women six times more than in men.
  • All benign thyroid disorders showed predominance in women. Male/female ratio was 1/10 (10%) in the TMG group and 6/12 (50%) in the NMG group in our study. We also found a significant difference in the incidence of malignancy in male patients between the two groups and the incidence of malignancy was found to be higher in the non-toxic male patients.

Region

  • [Disease name] is a common/rare disease that tends to affect [patient population 1] and [patient population 2].
  • Chiefly because of the iodination of table salt in the United States, the iodine intake of 200 to 600 μg/day in the United States is significantly higher than the nearly borderline deficient intake of 25 to 100 μg/day in many areas of Europe.
  • A higher incidence is seen in European countries in comparison with the United States. A general survey of six countries in Europe in 1986 revealed that 9% of thyrotoxic patients had autonomous nodules. In Malmo, Sweden, the mean annual incidence of thyrotoxicosis rose in 1988 to 1990 compared with the incidence in 1970 to 1974.

Developed Countries

References

  1. Siegel RD, Lee SL (1998). "Toxic nodular goiter. Toxic adenoma and toxic multinodular goiter". Endocrinol Metab Clin North Am. 27 (1): 151–68. PMID 9534034.
  2. Pelizzo MR, Bernante P, Toniato A, Fassina A (1997). "Frequency of thyroid carcinoma in a recent series of 539 consecutive thyroidectomies for multinodular goiter". Tumori. 83 (3): 653–5. PMID 9267482.
  3. Pinchera A, Aghini-Lombardi F, Antonangeli L, Vitti P (1996). "[Multinodular goiter. Epidemiology and prevention]". Ann Ital Chir (in Italian). 67 (3): 317–25. PMID 9019982.
  4. Gabriel EM, Bergert ER, Grant CS, van Heerden JA, Thompson GB, Morris JC (1999). "Germline polymorphism of codon 727 of human thyroid-stimulating hormone receptor is associated with toxic multinodular goiter". J. Clin. Endocrinol. Metab. 84 (9): 3328–35. doi:10.1210/jcem.84.9.5966. PMID 10487707.
  5. Tonacchera M, Vitti P, De Servi M, Agretti P, De Marco G, Chiovato L, Pinchera A (2003). "Gain of function TSH receptor mutations and iodine deficiency: implications in iodine prophylaxis". J. Endocrinol. Invest. 26 (2 Suppl): 2–6. PMID 12762632.
  6. Ríos A, Rodríguez JM, Balsalobre MD, Torregrosa NM, Tebar FJ, Parrilla P (2005). "Results of surgery for toxic multinodular goiter". Surg Today. 35 (11): 901–6. doi:10.1007/s00595-004-3051-7. PMID 16249841.

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