Nontoxic multinodular goitre
| Nontoxic multinodular goitre | |
|---|---|
| Other names | Nonactive multinodular goitre, inactive multinodular goitre |
| Enlarged neck swelling that represents a goiter | |
| Specialty | Endocrinology |
| Symptoms | Neck swelling, compressive symptoms of neck (difficulty breathing, difficulty swallowing, voice changes) |
| Causes | Iodine deficiency most common |
| Risk factors | Increasing age, female sex, lower socioeconomic status, genetics, smoking |
| Diagnostic method | Physical exam, thyroid function tests, ultrasound |
| Differential diagnosis | Toxic multinodular goitre, thyroid cancer, inflammatory thyroid disease |
Nontoxic multinodular goitre, also known as an inactive multinodular goitre, is an enlargement of the thyroid gland, which develops multiple nodules without affecting thyroid hormone function. In the United States it is the most common cause of an enlarged thyroid, affecting between 3 and 5% of the population. It often is asymptomatic but can present with painless swelling of the neck. Large goitres can present with difficulty swallowing, difficulty breathing, and/or voice changes from compressing nearby structures in the neck. The most common cause of nontoxic multinodular goitre is iodine deficiency, with risk factors including older age, female sex, and exposure to radiation. Management typically involves observation unless the goitre grows rapidly, causes compressive symptoms, or is concerning for cancer. In these cases, treatment can include surgery, radioactive iodine, or thyroid hormone suppression.