UNUSUAL TYPE OF HYPERTHYROIDISM

They are three well_recognised forms of hyperthyroidism
1. Graves' diseases (diffuse toxic goiter offen associated with exophthalmos)
2.Plummer's diseases (toxic multinodular goiter )
3.Toxic uninodular goiter (toxic adenoma )
This three types of hyperthyroidism are usually recognised easily by careful physical examination and radioisotope thyroidal scanning when other less common forms of hyperthyroidism have been excluded.
Additional types of hyperthyroidism listed by Committee on Nomenclature of the American Thyroid Association, are only rarely recognised clinically.
We have observed examples of some of these uncommon forms of hyperthyroidism and several varieties not specifically listed by the Committee on Nomenclature.
Since the etiology of the hyperthyroidism and appropriate treatment are quite variable, recognition of these rare forms of a common disorder is important. Some of these clinically situations represent variation of the common forms of hyperthyroidism with aspects that are potentially confusing and diagnostically challenging.
The purpose of this report is to review these less common varieties of hyperthyroidism from our own experience and that reported by others.
Iodide-induced hyperthyroidism was first recognised following the widespread use of iodine for goiter prophylaxis.
In 1925 Kimball reported his experience of 309 patients in whom hyperthyroidism was thought to occur the following the administration of iodine.
Most of these patients had long-standing goiters which were clinically or microscopycally adenomatous (multinodular). He emphasized that hyperthyroidism seemed related to the addition of prophylactic amounts of iodine to salt in only six of this case(2%) and that all others had received large amount of iodine(5-10 drops of Lugol's solution per day ot its equivalent).
More recent report have suggested that even small amounts of iodine may cause hyperthyroidism when previous iodine deficiency was present.
The following case demonstratest that patients with multinodular goiters of long duration living in area without endemic iodine deficiency, may develop hyperthyroidism after receiving large doses of iodine.
SOURCE FROM:
http://journals.lww.com/md-journal/Citation/1973/05000/Unusual_Types_of_Hyperthyroidism.2.aspx