[Pathogenesis, diagnosis and therapy of hyperthyroidism]

Different forms of hyperthyreosis have to be distinguished: Frequent forms: Basedow's disease (Graves' disease, autoimmunogenic hyperthyreosis), Plummer's disease (focal or disseminated functional autonomy). Rare forms: Hyperthyreosis with thyreoiditis. This 'morphologic' hyperthyreosis is due to a destruction caused by an infection combined with a release of the thyroid hormones. This transitory hyperthyreosis can be observed particularly in the beginning of a thyreoiditis De Quervain. The treatment of the inflammation eliminates the hyperthyreosis. Sometimes, a hyperthyreosis may also be observed during a Hashimoto-thyreoiditis which, however, will turn into a hypothyreosis. An increased TSH stimulation (secondary hyperthyreosis) is a rare disease which, i.e., may be due to a genetically caused hormone resistance in the periphery followed by an overproduction of TSH. The even more rare hyperthyreosis caused by a TSH producing tumor of the pituitary gland should also be mentioned. A hyperthyreosis during struma ovarii, trophoblast tumors and recently during interferon treatment are similarly rare. A 'hyperthyreosis factitia' in correlation with a permanent application of an overdose of thyroid hormones is observed only rarely in Germany. However, a hyperthyreosis caused by physicians is more frequent: The application of contrast mediums or other substances containing iodine during a hidden functional autonomy of the thyroid gland is taken into account for the diagnosis and treatment of the Plummer's disease.