Graves' disease Graves' disease (or Basedow-Graves disease) is an autoimmune disease. It most commonly affects the thyroid, frequently causing it to enlarge to twice its size or more (goiter), become overactive, with related hyperthyroid symptoms such as increased heartbeat, muscle weakness, disturbed sleep, and irritability. It can also affect the eyes, causing bulging eyes (exophthalmos). It affects other systems of the body, including the skin, heart, circulation and nervous system. It affects up to 2% of the female population, sometimes appears after childbirth, and occurs 7 to 8 times more often in women than in men.[1] Genetic factors are a major factor accounting for possibly around 80% of the risk.[2] Smoking and exposure to second-hand smoke is associated with the eye manifestations but not the thyroid manifestations. Signs and symptoms[edit] Graves' disease symptoms Cause[edit] The Immunoglobulin G antibody recognizes and binds to the thyrotropin receptor (TSH receptor). Diagnosis[edit]
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Pathogenesis of Graves' disease Graves' disease is a syndrome that may consist of hyperthyroidism, goiter, eye disease (orbitopathy), and occasionally a dermopathy referred to as pretibial or localized myxedema. The terms Graves' disease and hyperthyroidism are not synonymous, because some patients may have orbitopathy but no hyperthyroidism, and there are many other causes of hyperthyroidism in addition to Graves' disease. Hyperthyroidism is the most common feature of Graves' disease, affecting nearly all patients, and is caused by autoantibodies to the thyroid stimulating hormone (TSH, thyrotropin) receptor (TSHR-Ab) that activate the receptor, thereby stimulating thyroid hormone synthesis and secretion as well as thyroid growth (causing a diffuse goiter). The presence of TSHR-Abs in serum and orbitopathy on clinical examination distinguishes the disorder from other causes of hyperthyroidism. Other causes of an overactive thyroid gland are discussed separately. (See "Disorders that cause hyperthyroidism".)
Refdoc Refdoc est momentanément indisponible pour cause de maintenance. Nous vous prions de nous en excuser et vous invitons à vous reconnecter ultérieurement surwww.refdoc.fr Home Hyperthyroidism Hyperthyroidism, often referred to as an overactive thyroid, is a condition in which the thyroid gland produces and secretes excessive amounts of the free (not protein bound circulating in the blood[1]) thyroid hormones -triiodothyronine (T3) and/or thyroxine (T4). Graves' disease is the most common cause of hyperthyroidism.[2] The opposite is hypothyroidism ('sluggish thyroid'), which is the reduced production and secretion of T3 and/or T4.[3] Disease management and therapy differ for thyrotoxicosis caused by hyperthyroidism and thyrotoxicosis caused by other conditions. Thyroid imaging and radiotracer thyroid uptake measurements, combined with serologic data, enable specific diagnosis and appropriate patient treatment.[5] Symptoms and signs[edit] Illustration depicting enlarged thyroid that may be associated with hyperthyroidism Thyrotoxicosis or Hyperthyroidism may be asymptomatic, but when it is not, symptoms are due to an excess of thyroid hormone. Thyroid storm[edit] Causes[edit]
Hyperthyroidism and Graves' Disease Pretibial myxedema is a skin condition that may develop in patients with Graves’ disease. It is characterized by thickening of a layer of tissue that lies directly beneath the surface of skin called the dermis. The word “pretibial” refers to the fact that this thickening usually involves the skin that covers the front of the tibia bone in the lower leg. Pretibial myxedema usually becomes evident when raised lesions begin to appear on the skin that covers the front surfaces of the shins. While the underlying cause of pretibial myxedema is not completely understood, it has been suggested that it may represent an autoimmune disorder. On the whole, pretibial myxedema represents a relatively rare complication of Graves’ disease.
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