Graves' Disease Flashcards
Define Graves’ Disease?
The most common cause of hyperthyroidism
Caused by the presence of TSH-receptor stimulating antibodies that lead to hyperthyroidism due to loss of negative feedback
What is the aetiology of Graves’ Disease?
Caused by the presence of TSH-receptor stimulating antibodies
These antibodies are also responsible for the special features of Graves’ Disease (exophthalmos, pretibial myxoedema)
What are the risk factors for Hyperthyroidism?
Family History High Iodine Intake Smoking Trauma to the thyroid gland Toxic multinodular goitre HAART Childbirth
What is the epidemiology of Graves’ Disease?
Hyperthyroidism is COMMON
Graves’ is the most common cause of hyperthyroidism (75%)
Rarely occurs in children
What are the presenting symptoms of Graves’ Disease?
Weight loss despite increased appetite Irritability Weakness Diarrhoea Sweating Tremor Anxiety Heat Intolerance Loss of Libido Oligomenorrhoea/ amenorrhoea
What are the signs of Graves’ Disease on physical examination?
Palmar Erythema Sweaty and warm palms Fine tremor Tachycardia (may be AF) Hair thinning Urticaria/ pruritus Brisk reflexes Goitre Proximal myopathy Lid lag Gynaecomastia
What investigations would you do for Graves’ Disease?
TFTs
Autoantibodies
Imaging
Inflammatory Markers
What would you see for TFTs for Graves’ Disease?
low TSH + high T3/4
What autoantibodies would you see for Graves’ Disease?
Anti-TPO antibodies (thyroid peroxidase) - found in 75% of Graves
Anti-thyroglobulin antibodies
TSH-receptor antibodies - very sensitive and specific for Graves’ Disease
What imaging would you do for Graves’ Disease?
Thyroid US
Thyroid Uptake Scan
What Inflammatory Markers would you see for Graves’ Disease?
CRP/ESR will be raised in subacute thyroiditis
