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Table 91.1

Causes of Hyperthyroidism*

Autoimmune

Graves' disease

Hashitoxicosis

Postpartum thyroiditis

Infective

Subacute thyroiditis

Pyogenic thyroiditis

Neoplastic

Solitary adenoma

Toxic multinodular goitre

Differentiated thyroid carcinoma (rare, mostly follicular)

Secondary

TSHoma

Thyroid hormone resistance

Hyperemesis gravidarum

Hydatidiform mole/choriocarcinoma

Destructive

Amiodarone-induced thyrotoxicosis type 2 (AIT-2)

Trauma

Irradiation

Lithium

Iodine excess

(Jod-Basedow phenomenon)

Amiodarone-induced thyrotoxicosis type 1 (AIT-1)

Iodine contrast

Dietary (moving from iodine deficient to iodine rich area)

* Thyrotoxicosis is the syndrome resulting from supranormal thyroid hormone activity. It is usually the result of hyperthyroidism, defined as increased thyroid hormone production by the native thyroid gland. Other causes are oversupply of exogenous thyroid hormone in patients taking levothyroxine or other thyroid supplements, and very rarely, ectopic thyroid hormone production by an ovarian teratoma (struma ovarii).

Pathognomonic features of Graves' disease include the presence of thyroid eye disease, pretibial myxoedema, thyroid acropachy, or a bruit over the thyroid gland.