Graves' disease Flashcards
Define Graves’ disease
Most common cause of hyperthyroidism. Caused by presence of TSH-receptor stimulating antibodies that lead to hyperthyroidism due to loss of negative feedback
Aetiology of Graves’ disease
2
Caused by TSH-receptor stimulation antibodies
Antibodies responsible for special features of Graves’ (exophthalmos, pretibial myxoedema)
Risk factors for hyperthyroidism
7
FH High iodine intake Smoking Trauma to thyroid gland Toxic multi nodular goitre HAART Childbirth
Epidemiology of Graves’ disease
3
Hyperthyroidism is COMMON
Graves’ is the most common cause of hyperthyroidism (75%)
Rarely occurs in children
Presenting symptoms of Graves’ disease
10
Weight loss despite increased appetite Irritability Weakness Diarrhoea Sweating Tremor Anxiety Heat intolerance Loss of libido Oligomenorrhoea/amenorrhoea
Signs of Graves’ disease on physical examination
11
Palmar erythema Sweaty & warm palms Fine tremor Tachycardia (may be AF) Hair thinning Urticaria/pruritus Brisk reflexes Goitre Proximal myopathy Lid lag Gynaecomastia Exophthalmos Pretibial myxoedema
Investigations for Graves’ disease
4
TFTs
Autoantibodies
Imaging
Inflammatory markers
Investigations for Graves’ disease - TFTs
2
Low TSH
High T3/4
Investigations for Graves’ disease - autoantibodies
3
Anti TPO antibodies (thyroid peroxidase) - in 75%
Anti thyroglobulin antibodies
TSH receptor antibodies - v sensitive & specific for Graves’
Investigations for Graves’ disease - imaging
2
Thyroid US
Thyroid uptake scan
Investigations for Graves’ disease - inflammatory markers
CRP/ESR raised in subacute thyroiditis
