Local craw

General characteristic of a disease

The local craw is the increase in the sizes of a thyroid gland caused by an iodine deficiency in an organism.

As the reason of iodic insufficiency unbalanced food – insufficient consumption of fish, meat, a laminaria, shrimps, dairy products, oat and buckwheat grain, etc. can serve. About 90% of daily need for iodine of people receive exactly thanks to food.

Other possible reason of emergence of a local craw - the gastrointestinal diseases leading to bad absorption of microelements of iodine. At pathologies of intestines or stomach development of a local craw with full or partial iodic insufficiency is possible even if the diet of the patient is rich with the food stuffs containing iodine.

About 5% are made by the daily dose of iodine received by the person at the expense of water. As much again he receives thanks to the air sated with iodine microelements.

There are regions with the small content of iodine in the environment and, respectively, with high risk of development of a local craw. The midland of Russia inclusive with Moscow, for example, concerns to those. The iodine deficiency is observed also in areas with the raised background radiation.

Emergence of a local craw can sometimes provoke systematic reception of the medicines blocking digestion of iodine. Perchlorate, the Lity carry a carbonate, Nitrates, Streptocides to those Potassium, etc.

Also genetic predisposition to development of a local craw at genetic defect of production of thyroid hormones is possible.

Symptoms of a local craw

Increase (hyperplasia) in a thyroid gland at a local craw is a reaction of an organism to low concentration of iodine and the deficit of thyroid hormones caused by it. Quite often in parallel with a local craw the associated disease – a hypothyroidism develops.

Increasing the mass of a thyroid gland, the organism tries to compensate deficit of thyroid hormones, and it leads to emergence of the following symptoms of a local craw:

• weakness,
• small physical endurance,
• discomfort in heart,
• headache.

These symptoms of a local craw can be shown even at a subclinical stage of a disease with sizes of a thyroid gland within norm and at almost not changed level of thyroid hormones.

With the further growth of a thyroid gland new symptoms of a local craw appear:

• feeling of squeezing in area of a neck,
• the complicated swallowing and breath,
• dry cough,
• suffocation attacks.

Symptoms of a local craw of the heaviest stage are heart pathologies – the so-called development of goitrous heart expressed in expansion and hyperfunction of the right auricle and a ventricle.

Among possible complications of a local craw call hemorrhage of a thyroid gland, acute and subacute thyroidites, malignant regeneration of a nodal form of a disease.

Diagnosis of a local craw

In diagnosis of a local craw laboratory blood tests and urine are applied. The patient's blood with clinical symptoms of a local craw is checked for the level of TTG hormones, T3, T4, and also thyreoglobulin.

At patients with this type of a disease the balance of thyroid hormones is usually broken and the increased concentration of thyreoglobulin is observed. Indicators of releases of iodine in urine are, as a rule, reduced.

Tool diagnostic method of a local craw is ultrasonography. Thanks to it the disease form is established: diffusion or nodal local craw. By means of radio isotope scanning of a thyroid gland the functional condition of body is estimated.

At a nodal form of a local craw the biopsy of a thyroid gland is in addition applied to definition of the high-quality or malignant nature of a disease.

Treatment of a local craw

Tactics of treatment of a local craw depends on degree of a hyperplasia of a thyroid gland. At insignificant increase in the sizes of body there are often enough several rates of Potassium iodide. An obligatory part of treatment of a local craw of the I degree is also the dietotherapy the products rich with iodine.

Treatment of the local craw complicated by a hypothyroidism assumes purpose of replacement hormonal therapy. Levotiroksin is considered an artificial analog of hormones of a thyroid gland.

Treatment of a local craw of a nodal form at a late stage of a disease preferential surgical. For prevention of a recurrence of a hyperplasia of a thyroid gland in the postoperative period to the patient replacement hormonal therapy is carried out.

Prevention of a local craw

Effective prevention of development of a local craw is regular consumption of table iodized salt. It is extremely important to add salt to food after its preparation as microelements of iodine collapse heatings in time.

Also regular consumption of seafood, walnuts, persimmon allows to reduce probability of emergence of a local craw. Shall be present at a diet a fish dish and other products rich with iodine.

Local craw at children

Local craw at children – the most widespread iodine deficiency disease. Most often the diffusion form of a disease meets. According to statistical data over the last 10 years the frequency of occurrence of a local craw at children increased by 6% and makes about 25% of all children's endocrinological diseases today.

Such high rates of incidence are explained by the broken character of food and an adverse ecological situation. In a third of cases the local craw was diagnosed for children at teenage age (14 years and are more senior).

Characteristic symptoms of a local craw at children have more intensive expressiveness. Besides, at children's age the disease most often is complicated by development of local cretinism: delay of intellectual and physical development, frustration of TsNS.

Due to the high prevalence of a disease and serious consequences of a local craw at children prevention of a yododefitsit is recommended to be carried out, since pregnancy of mother and to continue during all life of the child.