title: [Diagnosis and therapy of patients with simple goiter within the scope of a thyroid gland ambulatory care service].
abstract: Serum thyroxin, triiodothyronine, and basal and TRH-stimulated TSH concentrations, were determined in 285 patients with simple goitre. In addition, the efficiency of two years' therapy with a T4/T3 preparation (ratio 4:1) was investigated. Patients with goitres of larger size (stage II und III) presented with lower serum T4 and higher serum T3 concentrations than patients with smaller goitres (stage I) and controls. A decreased or elevated TSH response to TRH stimulation was more frequently found among patients with large goitres than among those with small ones. No reduction of goitre size was achieved by thyroid hormone medication in patients in whom TSH response to TRH had been decreased prior to therapy. In contrast, a reduction in goitre size was registered after two years' therapy in 84% of the patients in whom the TRH-TSH response was elevated and in 44% in whom it was normal. Small and/or diffuse goitres were more responsive to T4/T3 medication than large and/or nodular ones. These results suggest that TSH stimulation tests are of diagnostic value in patients with simple goitre and should at any rate be performed in patients with goitres of larger size before the commencement of thyroid hormone medication. The data also demonstrate that suppression of TSH secretion via administration of thyroid hormone influences thyroid growth only in a subgroup of the goitrous patients of our region.
mesh_terms: D004338:Drug Combinations; D005260:Female; D006042:Goiter / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D008297:Male; D013972:Thyrotropin / Q000378:metabolism; D013974:Thyroxine / Q000008:administration & dosage* / Q000097:blood; D014284:Triiodothyronine / Q000008:administration & dosage* / Q000097:blood
chemical_list: D004338:Drug Combinations; D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine
vernacular_title: Diagnostik und Therapie bei Patienten mit blander Struma in Rahmen einer Schilddrüsenambulanz.