Hyperthyroidism--differential diagnosis and differential therapy

Thyrotoxicosis is one of the most common endocrine disorders, affecting approximately 2% of the adult population. Graves' disease and its variants are the most frequent cause. The prevalence of toxic nodular goitre and toxic adenoma is increased in areas of limited iodine supply. Thyrotoxicosis in patients with multinodular goitre can be precipitated by iodinated radiocontrast agents and the antiarrhythmic drug amiodarone. Transient hyperthyroidism may be caused by HCG-induced thyroiditis in pregnancy or de Quervain subacute thyroiditis. The differential diagnosis and the treatment principles of the varied causes of thyrotoxicosis are reviewed.