Malattia di Plummer (gozzo uninodulare tossico)
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Malattia di Plummer ( gozzo uninodulare tossico)
Che cos’è la malattia di Plummer?
La malattia di Plummer è dovuta a un adenoma follicolare iperfunzionante nell’ambito di una restante tiroide normale ed è la più frequente causa di ipertiroidismo nella popolazione generale di età compresa tra i 50 e i 60 anni, con simile incidenza nel sesso maschile e femminile.
Eziopatogenesi
L’adenoma di Plummer è causato da mutazioni somatiche a carico del sistema recettoriale del TSH che causano un’ attivazione incontrollata della cascata traduzionale con conseguenze iperstimolazione della crescita della funzione cellulare.
Quali soni i sintomi della malattia di Plummer?
La malattia dei Plummer si manifesta con la presenza di un nodulo tiroideo palpabile (di nuova diagnosi o già presente nella storia clinica del paziente) e con la diagnosi spesso legata alle complicanze d’organo dell’ipertiroidismo (fibrillazione atriale) più che ai sintomi e segni della tireotossicosi, che è spesso “subclinica” e di lunga durata.
Esami di laboratorio e strumentali
Il quadro bioumorale è rappresentato da livelli soppressi di TSH e alti livelli delle frazioni libere degli ormoni tiroidei. La scintigrafia mostra il classico aspetto di un’unica area nodulare calda circondata da parenchima tiroideo non captante.
Terapia
Le terapie di prima scelta nella malattia di Plummer sono la chirurgia e la terapia radiometabolica con 131Iodio (131I). Entrambe le due opzioni sono valide e hanno come obiettivo la distruzione/ rimozione della sola formazione nodulare con risparmio del circostante parenchima tiroideo sano.
Gozzo tossico diffuso-Malattia di Graves-Basedow
Articoli correlati

Noto come malattia di Graves nei paesi anglosassoni, è conosciuto in Europa come malattia di Basedow. Questa sindrome, che rappresenta la causa più frequente di tireotossicosi, comprende ipertiroidismo e quasi costantemente gozzo, cui possono accompagnarsi nel 40-90% dei casi orbitopatia (orbitopatia basedowiana), e, nel 3-15% dei casi, dermopatia (mixedema pretibiale). L’incidenza della malattia di Basedow è attorno all’ 1-2 casi per 1000 abitanti per anno, la prevalenza di circa
2,5-3%. La malattia colpisce più frequentemente il sesso
femminile. (Leggi articolo completo)






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