Graves Disease

Pathophysiology of Graves Disease 1) Graves disease is marked by hyperfunctioning of thyroid gland owing to stimulation by autoantibodies 2) has exacerbations and remissions 3) if untreated, leads to eventual thyroid failure Signs and Symptoms 1) fine hair 2) muscle wasting 3) exophthalmos 4) pretibial myxedema 5) fatigue/weakness 6) palpitations/nervousness/tremor/sweating 7) diffuse goiter 8) emotional lability 9) weight loss 10) tachycardia 11) bruit and thrill over thyroid 12) some Graves disease patients can have loss of eyebrows particularly laterally in the later stages of the disease Characteristic Test Findings Laboratory 1) heterogenous autoantibodies to TSH receptors (some of which are IgG) 2) increased T3 3) increased T4 Nuclear Medicine 4) increased radioiodine uptake by thyroid Histology/Gross Pathology 1) grossly symmetrical enlarged thyroid (diffuse thyroid hyperplasia) 2) cut surface is firm and beefy 3) highly vascular 4) enlargement of extraocular muscles 5) decrease of stored colloid Associated Conditions 1) atrial fibrillation 2) pernicious anemia 3) Hashimoto’s thyroiditis 4) increased frequency of HLA-B8 and HLA-DR3 in white patients 5) increased incidence in smokers with particularly serious eye sequelae Biochemistry 1) Type II hypersensitivity reaction 2) defect in antigen-specific suppressor T cells 3) sensitization to antigens of Yersinia enterocolitica plays a role Inheritance/Epidemiology 1) female to male, 9:1 2) affects 2-4% of USA popul...
Source: Inside Surgery - Category: Surgeons Authors: Tags: Endocrinology Source Type: blogs