[Thyroid gland nodules registered at the Endocrinology Department of the Medical Center in Prokuplje].

INTRODUCTION

Thyroid nodules are often found in clinical practice. General population prevalence is about 4%, whereas in women it is over 6%. The basic disorder of cell kinetics of thyroid tumors is inappropriate growth response to corresponding thyroid-stimulating hormone (TSH) concentration.

MATERIAL AND METHODS

At the Endocrinology Department of Medical Centre in Prokuplje, during the first year of practice (1997), 430 patients with thyroid gland disease were registered, both male and female belonging to different age groups. Patients were examined in regard to: sex, age, heredity, symptoms. Basic laboratory analyses were done with the aim to establish inflammatory syndromes: sedimentation, leukocytes, differential blood picture, cholesterolemia and fibrinogenemia; hormones of thyroid glands (T3, T4, TSH) with corresponding radioimmunoassay (RIA) technique. In the aim of identifying the nodules in the thyroid gland and perceiving nodular features, an ultrasound examining was done and scintigraphy of thyroid gland if necessary. Scintigraphy was done with radioactive technicium-99 mTc.

RESULTS

From the total number of registered patients (430) with thyroid gland disease, nodules were found in 172 glands (40%). The presence of thyroid nodules is more frequent in women (91.3%). The average age of thyroid gland patients is 50.33 years, of which men aged 52 and women aged 50.17. The following risk factors are stated as the most frequent: chronic stress 58.13%, consuming goiter substances 46.51% (cabbage, kale, sulphonamide). Swollen thyroid gland--goiter occurred in 105 cases (61.07%), whereas in 120 patients (69.32%) normal function was registered. In most cases the nodules are solitary 90 (52.32%). In 71.01% of patients cold nodules were found. In 36.04% of patients nodules were 1 to 1.9 cm in size. The greatest number of patients--83 (36.61%) complained of heart disorder as a symptom. 2.9% out of 172 patients with thyroid nodules underwent operation.

DISCUSSION

The obtained data mostly coincide with the findings of other authors. Trbojević found thyroid nodules 3 to 4 times more often with women. In this research it is ten times more frequent. Bozović especially pointed out the existence of inflammatory factors, mentioned in this group in 12.97% cases. We can not neglect the hereditary factor either--11.62% which is not clearly defined by other authors [1,2,3]. According to Trbojević, solitary nodules are present in 60% of cases. In this research the number is 52.32%. Cold nodules are found in 71.07% (according to Trbojević 90%). Only 2.9% of patients were operated, which is not enough if we follow all the medical indications.

CONCLUSION

Out of the total number of patients (430) with thyroid gland disease, 172 patients (40%) with nodular changes in thyroid glands have been found. Far more frequent (90%) are women aged 51 to 60 years (after menopause). The number of operated patients with thyroid nodules is insufficient.