GRAVES DISEASE-FEATURES

SUMMARY

1. Most common cause of thyrotoxicosis caused by TSH-receptor stimulating IgG auto-antibodies.

FEATURES

2. Diffuse, soft, symmetrical, non-tender goitre.

3. Graves opthalmopathy: exopthalmos, periorbital oedema & impaired extraocular movements. Leads to diplopia, corneal ulceration & visual impairment. 90% of patients suffer this. Radioactive iodine treatment is contraindicated in patients with severe eye inflammation.

4. Pretibial myxedema: erythema & thickening of the dermis due to lymphocytic infiltration. Different from hypothyroidism.

5. Haematologic abnormalities: anaemia, ITP.

SMOKING
6. Risk of opthalmopathy is increased in passive and active smokers. Smoking also adversely affects treatment.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].