What is Plummer's Disease?

Plummer's Disease is a condition where there is a single hyperfunctioning nodule producing excess thyroid hormone. Henry Plummer in 1913 described a clinically distinct form of thyrotoxicosis due to solitary or multiple toxic nodules in the thyroid. I restrict the term to a solitary a toxic nodule. This nodule is an adenoma (a benign tumour).

What are the Symptoms of Plummer's Disease?

The clinical features of a patient with Plummer's Disease are similar to a patient with Toxic Multinodular Goitre except that there is usually only one nodule. The nodule is not always readily palpable.

How is the diagnosis of Plummer's Disease made?

After clinical suspicion, the following investigations are performed:

1. Free T3 and T4 Levels
In classical cases, both T3 and T4 are elevated

2. Serum TSH Levels
Serum TSH levels are classically suppressed.

3. Radioactive Iodine or Technetium Scan
This shows a solitary nodule of uptake often known as a 'hot' nodule.

How is Plummer's Disease Treated?

The treatment of choice is either Radioactive Iodine (131-I) or surgical excision.