Graves’ Disease.

What is Graves Disease. Graves’ disease of the Thyroid is named after Dr Robert Graves, who first described it as early back in 1835.  Hyperthyroidism has several causes as it is explained hyperthyroidism and  Graves’  Thyroid disease is the most common cause of hyperthyroidism. Remember that hyperthyroidism is a condition and Graves’ disease is the auto immune disease,  responsible for that condition.

Graves disease statistics.

  • Graves disease usually presents itself in children and adolescents.
  • It affects 2% of the female population.
  • The incident ratio of female:male is between 5:1 to 10:1.
  • Hereditary component plays a very significant role.

Causes of Graves Disease of Thyroid.

  • It is caused by the auto immune system of the body itself. Therefore, people with an auto immune predisposition are more likely to contract this disease.
  • It is suspected that a viral or a bacterial infection may trigger off  the onset of this disease.

Symptoms of Graves Disease.

Symptoms of hyperthyroidism as explained “here” will be present. In addition, the following symptoms are seen:

  • Graves’ opthalmopathy or Graves’ eye disease is a characteristic symptom and is characterized by retracted eyelids, which cause the eyeball to protrude. This is called exophthalmus. There is blurring of vision, double vision and in advanced cases, there will be loss of vision.

Picture of The stare of Graves disease

  • Graves’ dermopathy or Graves’ Skin Disease. Due to the auto immune system of the body,  painless, thickened, reddish, patchy, raised skin rashes are seen usually on the lower  limbs. This incidence is not so common.

Picture of Graves’  Dermopathy

Aggravating factors of Graves’ Thyroid disease:

  • Smoking.
  • Radiation treatment given to the neck.
  • Viral infections.
  • Certain medications like IL-2, which are  given to improve the auto immune system of the body.

Complications of Graves’ Disease of Thyroid.

Thyroid storm may develop suddenly in patients of Graves’ disease. The onset may be triggered by a stressful situation. This can be life threatening and can cause heart failure, liver failure and kidney failure.

In thyroid storm, following symptoms are seen:

  • The patient becomes very irritable
  • Develops a rapid heart rate and high blood pressure
  • Has fever
  • Delirium is present
  • May go into coma if not controlled.

Diagnosis of Graves Disease of Thyroid.

Tests for Graves’ Disease include the following:

  • Blood tests for Thyroid Stimulating immunoglobin (TSI) levels show very high levels. TSH levels will be below normal, T4 levels may be slightly raised and T3 levels will definitely be elevated.
  • Thyroid Scan shows an increased uptake of iodine   over the entire thyroid gland.

Treatment of Graves’ Disease of Thyroid.

This treatment has been explained in “hyperthyroidism”. This a specialized endocrine therapy, and in short, will entail:

  • Anti Thyroid drugs.  Methimazole and Propylthiourasil (PTU)
  • Radioactive iodine therapy.  In  patients who have developed Graves opthalmopathy, radioactive iodine may worsen this condition, Your doctor will be careful in such cases and may advise steroids to fight this complication.
  • Surgery, if indicated will be partial thyroidectomy as malignancy due to Graves’ disease is not known. However, many physicians advise total thyroidectomy. In such cases, life long thyroid medicines have to be taken.