ROLE OF INFECTION IN THE ORIGIN, COURSE, RESULTS OF TREATMENT OF TOXIC GOITER
To date, the question of the causes of toxic goiter has not been resolved. Purpose: to analyze the role of infection in the occurrence, course, treatment outcome of toxic goiter. Observed in the dynamics of 64 patients with toxic goiter. In 36% of cases, thyrotoxicosis manifested itself after acute infections. Foci of chronic bacterial infection were detected in 59 (92.2%) patients. Serological indices of persistence of herpes simplex virus, Epstein- Barr, cytomegalovirus (HSV, EBV, CMV) were high in all patients with suspected viral persistence (n = 20). In 1/3 of the observations a combined infection was established. The infection was cured in 34 patients. The infection was not cured in 30 patients. The observations showed that acute and chronic bacterial and viral infections can provoke the onset of toxic goiter, worsen its course, reduce the effectiveness of therapy, affecting the main link in the pathogenesis of the disease - the activity of the autoimmune process in the thyroid gland. Infection exacerbations stimulate the production of AT-rTTG, leading to relapses thyrotoxicosis. Conclusion: although infection is not the main etiological factor of toxic goiter, its role in the manifestation, course of toxic goiter, the effectiveness of therapy, and the distant prognosis is undeniable. Starting treatment for toxic goiter, in including planning surgical treatment or radioiodine therapy, it is necessary to identify and sanitize foci of infection, to check the possible persistence of common viruses of herpes simplex, Epstein-Barr, cytomegalovirus. This will improve the prognosis, reduce the high risks of thyrotoxicosis relapses.