Congenital Goiter

Congenital goiters may be caused by the following:

The thyroid gland Overview of the Thyroid Gland The thyroid is a small gland, measuring about 2 inches (5 centimeters) across, that lies just under the skin below the Adam’s apple in the neck. The two halves (lobes) of the gland are connected... read more secretes thyroid hormone. Any thyroid gland disorder that decreases production of thyroid hormone causes the pituitary gland Overview of the Pituitary Gland The pituitary is a pea-sized gland that is housed within a bony structure (sella turcica) at the base of the brain. The sella turcica protects the pituitary but allows very little room for expansion... read more to secrete more thyroid-stimulating hormone (TSH). If a disorder prevents the thyroid gland from responding normally by increasing hormone output, the increased stimulation by TSH causes the thyroid gland to enlarge. There are many genetic abnormalities that decrease the thyroid gland's ability to produce thyroid hormone and cause congenital goiter.

Women who have certain thyroid disorders such as Graves disease Graves disease Thyroid disorders may be present before women become pregnant, or they may develop during pregnancy. Being pregnant does not change the symptoms of thyroid disorders. How the fetus is affected... read more sometimes produce antibodies that cross the placenta during pregnancy. These antibodies interact with the receptor for TSH and can cause the fetus to produce too much thyroid hormone (hyperthyroidism Hypothyroidism Hypothyroidism is underactivity of the thyroid gland that leads to inadequate production of thyroid hormones and a slowing of vital body functions. Facial expressions become dull, the voice... read more ) or too little thyroid hormone (hypothyroidism Hypothyroidism in the Newborn Hypothyroidism is decreased production of thyroid hormone. Hypothyroidism in the newborn may occur if there is a structural problem with the thyroid gland. Symptoms may include delayed growth... read more ). But in both cases, a goiter may result. In affected infants, the goiter typically resolves spontaneously within 3 to 6 months.

Drugs such as amiodarone, propylthiouracil, iodine, and methimazole taken by the mother can cross the placenta and may rarely cause congenital goiter.

The most common symptom of congenital goiter is firm and symmetric enlargement of the thyroid. There is no tenderness. The entire gland may be enlarged or only portions of it. It may be noticeable at birth or detected later. If the enlargement continues, infants may have difficulty breathing and swallowing. Many infants with goiters have a normally functioning thyroid gland. However, some infants develop hypothyroidism or hyperthyroidism.

If doctors suspect the infant has a goiter, they do ultrasonography Ultrasonography Ultrasonography uses high-frequency sound (ultrasound) waves to produce images of internal organs and other tissues. A device called a transducer converts electrical current into sound waves... read more to measure the size of the thyroid.

Tests are done to determine levels of thyroid hormones in the blood (see Thyroid function tests Thyroid function tests The thyroid is a small gland, measuring about 2 inches (5 centimeters) across, that lies just under the skin below the Adam’s apple in the neck. The two halves (lobes) of the gland are connected... read more ).

Infants who have hypothyroidism are given replacement thyroid hormone therapy by mouth.

Goiters that cause breathing and swallowing difficulty can be treated surgically.