Plummer’s Disease : causes, symptoms, prognosis, treatment 

Plummer’s Disease is similar to hyperthyroidism with symptoms of inflammation in the thyroid gland and its symptoms are mostly found in aged people is called Plummer’s disease and is also known as Toxic Multi-nodular goiter.


In this disease, thyroid gland is enlarged and thyroid hormones are produced in excessive amount. (TNG) Toxic Nodular is also called Plummer’s disease. It is the main cause of spreading hyperthyroidism in European countries.

It can be defined as the enlargement of thyroid gland which consists of a small mass or small masses in round shape which are called nodules and it produces thyroid hormones in excess.

TNG or Plummer disease is caused by simply long-lasting goiter mostly in elder age. Apparently, it looks like the symptoms of hyperthyroidism. But the symptoms of Grave’s disease are not showed like bulging eye balls.

 The symptoms of this disease are not found and observed in children but mostly found and observed in old persons while it becomes riskier for women and people of 55 or above age.

A disease group in which secretory system of a person is enlarged and a huge number of hormones is produced in thyroids. The cases of TNG or Plummer disease are not found and observed in Japan.

Historical background of Plummer’s disease:

Henry Plummer gave the idea of two different types of people who were facing hyperthyroidism in 1913.

It was the result of his clinical and medical research during 1910 to 1913 and during this period observed more than three thousand patients who were operated upon due to surgical pathology.

 The results which were extracted that were explained by Boothby, the pioneer of BMR and Wilson, a pathologist that both types of goiter Adenomatous and Exophthalmic are two separate structures.

 The second type is correlated with disperse hyperplasia in thyroid gland and the whole gland is involved in destructing the hyperthyroidism.

Round about 99.9% of the patients of goiters are correlated with malignant and toxic condition. 20% patients of hyperplasia are linked with overspread or enlargement of aged Adenomatous goiter.

23% of this goiter Adenomatous is correlated with the clinical hyperthyroidism. These may consist of a singular or plural necrotic, granular, calcareous, abscess fibrous, effusion, inorganic adenoma in the abnormal or surfactant thyroid.

Local reaction plays a vital role in the enlargement of the gland, hyperthyroidism and it is also another page of Endemic goiter.

Causes of Plummer’s Disease 

Poisonous nodular goiter begins from a current basic goiter. It happens regularly in more seasoned grown-ups. Hazard factors incorporate being female and more than 55 years of age.

This issue is uncommon in youngsters. The vast majority who create it have had a goiter with knobs for a long time. Once in a while the thyroid organ is just somewhat developed, and the goiter was not as of now analyzed.

Some of the time, individuals with poisonous multinodular goiter will grow high thyroid levels interestingly. This for the most part happens after they take in a lot of iodine through a vein (intravenously) or by mouth.

The iodine might be utilized as differentiation for a CT sweep or heart catheterization. Taking medications that contain iodine, like amiodarone, may likewise prompt the confusion.

Moving from a country with iodine lack to a country with a ton of iodine in the eating regimen can likewise transform a straightforward goiter into a harmful goiter.

Symptoms of Plummer disease

Anxiety, restlessness, expanded appetite, mental and physical fatigue, weakness and weight loss, over-sweetening, bigotry of heat, constipation, intestine problems, pain in muscles and irregular routine of menses in females.

It is observed during the physical examination of a person who was suffering from nodules in the thyroid gland that the heartbeat of that patient is high.

Through the Thyroid scan it can check that how exalted iodine has been guffed in the multi nodules. The amount of TSH (thyroid-stimulating hormone) serum becomes very low. T3 and T4, the levels of Serum thyroid hormone disappeared or vacated.

Treatment of Plummer disease

Some treatment methods are mentioned for Plummer’s disease which may be useful for the treatment of this disease. Anti-thyroid drugs may be used as a treatment to avoid surgical issues.

 If hormone levels of the thyroid gland in the body are controlled, Beta-blockers like Propranolol or others may be used. If it is not recovered through medicines then other methods like surgery and radioactive may be applied for further treatment.

Radioactive iodine treatment

An old woman of 72 year was diagnosed as a patient of Plummer disease who did not care and attend to his goiter for seven years; as a result, the disease continuously destructs her.

TSH (thyroid stimulating hormones) and low and high levels of thyroid hormones were declared by the laboratories but no symptom of hyperthyroidism was declared in clinical test.

Before the proper treatment, the patient was admitted 485 MBQ with radioactive of iodine 135 and there was no restriction of in taking the doze of iodine. After the treatment, the levels of hormones of patient become normal.

 According to the wish of the patient, the treatment of radioiodine therapy was adopted

rather than radical surgery which was also a second option for the treatment.

Clinical history of Plummer patient:

As we have already discussed that the patient is an old woman of 72 years. After her clinical examination, it is declared that the old woman had been suffering from thyroid gland for last 7 years.

 Our objective is to find out the reason which reached her to that stage. Actually, she ignored the thyroid gland which leads her to this critical and severe condition.

After the duration of seven years, her urologist advised her for a complete examine due to anomalous levels of hormones and goiter.


Harmful nodular goiter is chiefly an illness of more established grown-ups. Along these lines, other constant medical issues may influence the result of this condition.

 A more established grown-up might be less ready to endure the impact of the sickness on the heart. Be that as it may, the condition is frequently treatable with medications.


  • Heart confusions:
  • Cardiovascular breakdown
  • Sporadic heartbeat (atrial fibrillation)
  • Fast pulse
  • Different confusions:
  • Bone misfortune prompting osteoporosis
  • Thyroid emergency or tempest is an intense deteriorating of hyperthyroidism indications. It might happen with contamination or stress.
  • Thyroid emergency may cause:
  • Stomach torment
  • Diminished mental readiness
  • Fever

Individuals with this condition need to go to the emergency clinic immediately. Difficulties of having an exceptionally huge goiter may incorporate trouble breathing or gulping.

These confusions are because of tension on the aviation route entry (windpipe) or throat, which lies behind the thyroid.

When to Contact a Medical Professional

Call your medical care supplier in the event that you have side effects of this problem recorded previously. Adhere to the supplier’s directions for follow-up visits.


To forestall poisonous nodular goiter, treat hyperthyroidism and straightforward goiter as your supplier proposes.

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