Grave’s Disease

Defination
 An immune system disorder that attacks the thyroid causing to produce more thyroid
hormones (hyperthyroidism)
 It is the most common cause of hyperthyroidism accounts for 60–80% of hyperthyroid cases.
 Occurs in up to 2% of women but is one-tenth as frequent in men.
 Occurs between 20 and 50 years of age.

Etiology
 The exact etiology of the initiation of the autoimmune process in Graves’ disease is not known.
However, conditions such as the postpartum state, iodine excess, lithium therapy, and bacterial
and viral infections have been suggested as possible triggers.

Risk Factor
 Family history
o Because a family history of Graves' disease is a known risk factor, there is likely a gene
or genes that can make a person more susceptible to the disorder.
 Sex
o Women are much more likely to develop Graves' disease than are men.
 Age
o Graves' disease usually develops in people before age 40.
 Other autoimmune disorders.
o People with other disorders of the immune system, such as type 1 diabetes or
rheumatoid arthritis, have an increased risk.
 Emotional or physical stress
o Stressful life events or illness may act as a trigger for the onset of Graves' disease
among people who have genes that increase their risk.
 Pregnancy
o Pregnancy or recent childbirth may increase the risk of the disorder, particularly among
women who have genes that increase their risk.
 Smoking
o Smoking is a minor risk factor for Graves’ disease and a major risk factor for the
development of ophthalmopathy.

Clinicl features:
 The clinical manifestations of Graves’ disease can be divided into those related to
hyperthyroidism and those specific to Graves’ disease. Hyperthyroid symptoms include heat
intolerance, increased sweating and thirst, and weight loss despite adequate caloric intake.
 Symptoms of increased adrenergic stimulation include palpitations, nervousness, fatigue,
emotional lability, hyperkinesis, and tremors. The most common GI symptoms include
increased frequency of bowel movements and diarrhea.

Triad of Grave’s disease:

Diffuse goiter
Ophthalmopathy
Dermopathy (pretibial myxedema)