I
HYPERTROPHIC PULMONARY OSTEOARTHROPATHY
SYMPTOMS AND SIGNS OF HYPERTHYROIDISM
Hyperthyroidism (oversecretion of
thyroid hormones) produces a range of
symptoms associated with overactivity
of the body’s metabolism. Early signs
of the condition include weight loss,
increased appetite, intolerance to heat,
and increased sweating; there may
also be tremors and a rapid heart rate.
One form of the condition, called
Graves’ disease, may cause
bulging eyes. In severe cases of
hyperthyroidism, the thyroid gland is
often enlarged, causing a visible
swelling (goitre) in the neck, and there
tends to be physical and mental
hyperactivity and muscle wasting.
P r o t r u d in g e y e s
T h is s y m p t o m ( k n o w n a s
e x o p h t h a l m o s ) a f f e c t s
3 0 - 5 0 p e r c e n t o f p e o p l e
w it h G r a v e s ’ d i s e a s e .
T h y r o id g l a n d e n l a r g e m e n t
T h is s y m p t o m ( k n o w n a s g o i t r e ) m a y b e
d u e t o h y p e r t h y r o i d i s m ; h o w e v e r , i t m a y
a l s o b e a s s o c i a t e d w ith h y p o t h y r o i d i s m
( u n d e r a c t iv it y o f t h e t h y r o i d g l a n d ) .
M u s c l e w a s t i n g
S e v e r e h y p e r t h y r o i d i s m m a y c a u s e
w a s t in g o f b o t h s k e l e t a l a n d h e a r t m u s c l e .
I n c r e a s e d a p p e t i t e
T h is s y m p t o m i s a r e s u l t o f m e t a b o l i c
o v e r a c t i v it y , c a u s i n g i n c r e a s e d e n e r g y u s e .
D e s p i t e i n c r e a s e d a p p e t i t e , t h e a f f e c t e d
p e r s o n m a y l o s e w e ig h t .
HYPERTHYROID HEART RATE
Excessively high levels ofthyroid
hormones mayspeed up the heart
rate and mayalso cause an irregular
heart rhythm.
L
V
-
jL
Healthy heartbeat
This diagram of an
E C G
trace shows a normal
heart rate and rhythm.
Hyperthyroid heartbeat
This trace shows the fast, irregular rate and
rhythm seen in hyperthyroidism.
Qgn
Appearance of exophthalmos
In people with Graves’ disease, overactivity ofthe
thyroid may cause swelling ofthe tissues around one
or both eyes, resulting in a staring appearance.
H
t h e
r e m o v a l
o f
p a r t
o f
t h e
t h y r o i d
g l a n d . P e o p l e s u f f e r i n g f r o m h y p e r t h y -
r o i d i s m m a y b e g i v e n r a d i o a c t i v e i o d i n e
t o d e s t r o y p a r t o f t h e t h y r o i d t i s s u e .
M a n y p e o p l e r e c o v e r f u l l y a f t e r t r e a t -
m e n t , b u t t h e i r h o r m o n e l e v e l s n e e d t o
b e m
o n i t o r e d r e g u l a r l y s o t h a t a n y f u r -
t h e r
a b n o r m a l
c h a n g e s
c a n
e a s i l y
b e
d e t e c t e d
a n d
t r e a t e d .
T r e a t m e n t
w i t h
r a d i o a c t i v e i o d i n e m a y r e s u l t i n d e v e l -
o p m e n t o f
h y p o t h y r o i d i s m
( u n d e r a c t i v i t y
o f t h e t h y r o i d g l a n d ) .
h y p e rto n ia
I n c r e a s e d r i g i d i t y i n a m u s c l e . H y p e r t o -
n i a m a y b e
c a u s e d b y
d a m a g e t o t h e
n e r v e s
s u p p l y i n g
t h e
m u s c l e
o r
b y
c h a n g e s
w i t h i n
t h e
m u s c l e
i t s e l f . T h e
c o n d i t i o n
c a u s e s
e p i s o d e s
o f c o n t i n u -
o u s m u s c l e s p a s m . P e r s i s t e n t h y p e r t o n i a
i n l i m b m u s c l e s f o l l o w i n g a
s t r o k e
o r
h e a d i n j u r y
l e a d s t o
s p a s t i c i t y .
h y p e rto n ic s o lu tio n
A f l u i d t h a t i s m o r e c o n c e n t r a t e d t h a n
b l o o d p l a s m a o r t h e f l u i d w i t h i n c e l l s . I f
a h y p e r t o n i c s o l u t i o n i s i n t r o d u c e d i n t o
t h e b o d y , w a t e r w i l l p a s s f r o m t h e c e l l s
i n t o
t h e s o l u t i o n
( s e e
o s m o s i s
).
I f t h e
s o l u t i o n i s t o o c o n c e n t r a t e d , t h e b o d y ’s
c e l l s m a y l o s e t o o m
u c h w a t e r .
F l u i d s
u s e d f o r i n t r a v e n o u s i n f u s i o n a r e u s u a l l y
i s o t o n i c
( h a v i n g t h e s a m e c o n c e n t r a t i o n
a s t h e f l u i d s i n c e l l s ) ; i f t h e y a r e b e i n g
u s e d t o t r e a t d e h y d r a t i o n , i n f u s e d f l u i d s
a r e m i l d l y
h y p o t o n i c
.
h y p e rtric h o s is
G r o w t h
o f e x c e s s i v e
h a i r
,
a l l
o v e r t h e
b o d y ,
e v e n i n p l a c e s t h a t a r e n o t n o r -
m a l l y h a i r y H y p e r t r i c h o s i s o f t e n o c c u r s
a s
a
r e s u l t
o f
t a k i n g
c e r t a i n
d r u g s
( i n c l u d i n g
c i c l o s p o r i n
a n d
m i n o x i d i l
).
I t
m a y a l s o b e a s s o c i a t e d w i t h
a n o r e x i a n e r -
v o s a
.
I n
a d d i t i o n ,
t h e
t e r m
“ h y p e r -
t r i c h o s i s ”
i s
u s e d
t o
d e s c r i b e
h a i r
g r o w t h i n a m
o l e ( s e e
n a e v u s
).
H y p e r t r i c h o s i s i s n o t t h e s a m e a s
h i r -
s u t i s m
,
w h i c h i s e x c e s s i v e h a i r g r o w t h
( p a r t i c u l a r l y i n w o m e n )
d u e t o a b n o r -
m a l l e v e l s o f m a l e h o r m o n e s .
h y p e rtro p h ic c a rd io m y o p a th y
A d i s e a s e o f t h e h e a r t m u s c l e ( s e e
c a r -
d i o m y o p a t h y
)
i n w h i c h t h e w a l l s o f t h e
l e f t
v e n t r i c l e
( t h e h e a r t ’s l o w e r c h a m b e r )
b e c o m
e a b n o r m a l l y t h i c k e n e d , p r e v e n t -
i n g t h e h e a r t f r o m p u m p i n g e f f i c i e n t l y .
T h i s m a y l e a d t o b r e a t h l e s s n e s s ,
c h e s t
p a i n , a n d
p a l p i t a t i o n s
.
H y p e r t r o p h i c c a r d i o m y o p a t h y i s m o s t
c o m
m o n l y i n h e r i t e d ,
a n d i t s h o w s a n
a u t o s o m a l d o m i n a n t p a t t e r n o f i n h e r i -
t a n c e
( s e e
g e n e t i c
d i s o r d e r s
).
F a m i l y
m e m b e r s c a n b e s c r e e n e d
( s e e
f a m i l i a l
s c r e e n i n g
)
b y
m e a n s
o f
e c h o c a r d i o g r a -
p h y
,
a l t h o u g h
t h e
c o n d i t i o n
m a y
n o t
b e c o m
e
a p p a r e n t
u n t i l
a f t e r
p u b e r t y .
H y p e r t r o p h i c c a r d i o m y o p a t h y i s s o m
e -
t i m e s
a
c a u s e
o f
s u d d e n
d e a t h
( s e e
d e a t h , s u d d e n
)
i n y o u n g p e o p l e .
T r e a t m e n t i s w i t h
a n t i a r r h y t h m i c d r u g s
a n d ,
i n
s o m e
c a s e s ,
a n
i m p l a n t a b l e
d e f i b r i l l a t o r ( s e e
d e f i b r i l l a t i o n
).
h y p e rtro p h ic p u lm o n a ry
o s te o a rth ro p a th y
A c o n d i t i o n i n w h i c h s e v e r e p a i n a n d
s w e l l i n g
o f
t h e
w r i s t s
a n d
a n k l e s
i s
a s s o c i a t e d w i t h
c l u b b i n g
o f t h e e n d s o f
t h e f i n g e r s a n d t o e s . T h e m o s t c o m m o n
c a u s e
o f t h e
c o n d i t i o n
i s
l u n g c a n c e r
.
X - r a y s
o f t h e a f f e c t e d b o n e s s h o w n e w
b o n e f o r m a t i o n i n t h e l o n g b o n e s n e a r
399
previous page 398 BMA A Z Family Medical Encyclopedia   2004 read online next page 400 BMA A Z Family Medical Encyclopedia   2004 read online Home Toggle text on/off