Graves' hyperthyroidism
Graves' disease is an autoimmune disease mediated by thyroid-stimulating IgG immunoglobulins directed against the TSH receptor, resulting in hyperthyroidism.
The autoimmune process involved in Graves' disease also typically is directed to soft tissues within the orbit - this results in inflammation and swelling, with periorbital oedema, proptosis, and ophthalmoplegia (Graves' ophthalmology).
The presence of pre-tibial myxoedema in association with hyperthyroidism is diagnostic but is uncommon, occurring in about 6% of cases.
Estimated prevalence of different aspects of Graves' disease:
- hyperthyroidism and diffuse goitre - 95%
- thyroid eye disease - 50%
- pretibial myxoedema - 6%
- acropachy - 1%
- thyroid eye disease without hyperthyroidism ['Euthyroid Graves' disease'] - 5%
The natural history is one of alternating relapse and remission; less than 40% of patients have a single episode during their lifetime.
Reference:
- Wémeau JL et al. Graves' disease: Introduction, epidemiology, endogenous and environmental pathogenic factors. Ann Endocrinol (Paris). 2018 Dec;79(6):599-607
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