Thyroid appearance of cells is viewed to determine whether they resemble normal or cancerous cells. There can be many nodules, which is termed a multinodular goitre, and this can sometimes be a toxic multinodular goitre. An enlarged thyroid gland is called a goitre. Goitres are present in some form in about 5% of people, and are the result of a large number of causes, including iodine deficiency, autoimmune disease (both Grave's disease and Hashimoto's thyroiditis), infection, inflammation, and infltrative disease such as sarcoidosis and amyloidosis. Sometimes no cause can be found, a state called "simple goitre". Some forms of goitre are
Isobutyryl-coenzyme A dehydrogenase deficiency Isobutyryl-coenzyme A dehydrogenase deficiency Isobutyryl-coenzyme A dehydrogenase deficiency, commonly known as IBD deficiency, is a rare metabolic disorder in which the body is unable to process certain amino acids properly. People with this disorder have inadequate levels of an enzyme that helps break down the amino acid valine, resulting in a buildup of valine in the urine, a symptom called valinuria. Defects in the "ACAD8" gene cause isobutyryl-coenzyme A dehydrogenase deficiency. The "ACAD8" gene provides instructions for making an enzyme that plays an essential role in breaking down proteins from the diet. Specifically, the enzyme is responsible for processing valine,