[23]
Toxic multinodular goitre is a common cause of hyperthyroidism in communities having adequate iodine intake, first being Graves' disease.
In these patients the underlying thyroid disease is most commonly Graves' disease but ANCA positive vasculitis has also been seen with association with
toxic multinodular goitre (4).
An ASA 2 patient with body mass index 37.8 was scheduled for an elective thyroidectomy for
toxic multinodular goitre. The patient also had a history of obstructive sleep apnoea.
Molecular pathogenesis of euthyroid and
toxic multinodular goitre. Endocrine Reviews 2005;26(4):504-24.
The commonest indication for total thyroidectomy in both the groups was Euthyroid multinodular goitre (MNG), followed by
toxic multinodular goitre, Graves disease and malignancy (Table-1).
The majority of cases of hyperthyroidism associated with thyrotoxic periodic paralysis are due to Graves disease although other conditions including thyroiditis,
toxic multinodular goitre, toxic adenoma, TSH secreting pituitary tumour, ingestion of T4 and inadvertent iodine excess have also been implicated.