Graves’ Disease

Sanjay Saran
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Abstract

Graves’ disease (GD) is an autoimmune disorder characterized by presence of TSH receptor autoantibody. It is most common cause of hyperthyroidism worldwide. Though GD can occur any age but peak incidence is seen during adulthood in between 20 to 50 years of age. GD is more commonly seen in female. GD is primarily disease of thyroid gland but affects multi organ system i.e. heart, liver, muscle, eye and skin. Symptoms and signs are result from hyperthyroidism or a consequence of underlying autoimmunity. Weight loss, fatigue, heat intolerance, tremor, and palpitations are the most common symptoms. Diffuse goiter presents in most of younger patients with thyrotoxicosis but less common in older patients. Graves’ ophthalmopathy and pretibial myxedema are extrathyroidal manifestations of GD which results from action of TSHR autoantibodies on TSHR present onfibroblast, adipocyte and T cells in extrathyroidal tissue. Treatment of GD remains in between antithyroid drugs, radioiodine or surgery. In this review we discuss the diagnosis and management of GD.
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甲状腺机能亢进
Graves病(GD)是一种以TSH受体自身抗体存在为特征的自身免疫性疾病。它是世界范围内甲状腺功能亢进最常见的原因。虽然GD可以发生在任何年龄,但发病率高峰见于20至50岁之间的成年期。GD多见于女性。GD主要是甲状腺疾病,但影响多器官系统,如心脏、肝脏、肌肉、眼睛和皮肤。症状和体征是由甲状腺机能亢进或潜在的自身免疫引起的。体重减轻、疲劳、热不耐、震颤和心悸是最常见的症状。弥漫性甲状腺肿出现在大多数甲状腺毒症的年轻患者中,但在老年患者中较少见。Graves眼病和胫前黏液水肿是GD的甲状腺外表现,是由甲状腺外组织中存在于成纤维细胞、脂肪细胞和T细胞的TSHR自身抗体作用所致。GD的治疗仍然在抗甲状腺药物、放射性碘或手术之间进行。本文就GD的诊断和治疗作一综述。
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Graves’ Disease Graves Disease in Childhood Graves’ Disease
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