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Encyclopedia > Graves' disease

Graves' disease is a thyroid disorder characterized by goiter, exophthalmos, and hyperthyroidism. It is caused by an antibody-mediated auto-immune reaction, but the trigger for this reaction is still unknown. It is the most common cause of hyperthyroidism in the world, and the most common cause of general thyroid enlargement in developed countries. A goitre (BrE), or goiter (AmE) (Latin struma), also called a bronchocele, is a swelling in the neck (just below Adams apple or larynx) due to an enlarged thyroid gland. ... Exophthalmos (or proptosis) is a bulging of the eye anteriorly out of the orbit. ... Hyperthyroidism (or overactive thyroid gland) is the clinical syndrome caused by an excess of circulating free thyroxine (T4) or free triiodothyronine (T3), or both. ... Each antibody binds to a specific antigen; an interaction similar to a lock and key. ... Autoimmune diseases arise from an overactive immune response of the body against substances and tissues normally present in the body. ...


In some parts of Europe the term Basedow's disease or Graves-Basedow disease is preferred to Graves' disease.

Contents

History

Graves' disease owes its name to the Irish doctor Robert James Graves,[1] who described a case of goiter with exophthalmos in 1835. However, the German Karl Adolph von Basedow independently reported the same constellation of symptoms in 1840. As a result, on the European Continent the term Basedow's disease is more common than Graves' disease.[2][3] | Come and take it, slogan of the Texas Revolution 1835 was a common year starting on Thursday (see link for calendar). ... Karl Adolph von Basedow (March 28, 1799 – April 11, 1854) was a German physician most famous for reporting the symptoms of what could later be dubbed Graves-Basedow disease. ... 1840 is a leap year starting on Wednesday (link will take you to calendar). ...


Several earlier reports exist but were not widely circulated. For example, cases of goiter with exophthalmos were published by the Italians Giuseppe Flajani and Antonio Giuseppe Testa, in 1802 and 1810 respectively.[4] Prior to these, Caleb Hillier Parry, a notable provincial physician in England of the late 18th-century (and a friend of Edward Jenner),[5] described a case in 1786. This case was not published until 1825, but still ten years ahead of Graves[6] As a means of recording the passage of time, the 18th century refers to the century that lasted from 1701 through 1800 in the Gregorian calendar. ... Edward Jenner, FRS, (May 17, 1749 – January 26, 1823) was an English scientist who studied his natural surroundings in Berkeley, Gloucestershire, England. ...


However, fair credit for the first description of Graves' disease goes to the 12th-century Persian physician Sayyid Ismail Al-Jurjani, who noted the association of goiter and exophthalmos in his Thesaurus of the Shah of Khwarazm, the major medical dictionary of its time.[2] link title Media:Example. ... Anthem SorÅ«d-e MellÄ«-e Īrān Â² Capital (and largest city) Tehran Official languages Persian Demonym Iranian Government Islamic Republic  -  Supreme Leader  -  President Unification  -  Unified by Cyrus the Great 559 BCE   -  Parthian (Arsacid) dynastic empire (first reunification) 248 BCE-224 CE   -  Sassanid dynastic empire 224–651 CE   -  Safavid dynasty... This article is being considered for deletion in accordance with Wikipedias deletion policy. ...


Diagnosis

Graves' disease may present clinically with one of the following characteristic signs:

  • exophthalmos (protuberance of one or both eyes)
  • a non-pitting edema (pretibial myxedema) with thickening of the skin, described as "peau d'orange" or "orange peel", usually found on the lower extremities
  • fatigue, weight loss with increased appetite, and other symptoms of hyperthyroidism

The two signs that are truly diagnostic of Graves' disease (i.e. not seen in other hyperthyroid conditions) are exophthalmos and non-pitting edema (pretibial myxedema). Goiter, which is caused by an enlarged thyroid gland and is diffusion goiter by nature, can be present with other forms of hyperthyroidism, although Graves' disease is the most common cause. A large goiter is visible to the naked eye, but a smaller goiter may not be clinically detectable, though X-rays or ultrasound can assist in detecting it. Exophthalmos (or proptosis) is a bulging of the eye anteriorly out of the orbit. ... This page is about the condition called edema. ... Hyperthyroidism (or overactive thyroid gland) is the clinical syndrome caused by an excess of circulating free thyroxine (T4) or free triiodothyronine (T3), or both. ... In the NATO phonetic alphabet, X-ray represents the letter X. An X-ray picture (radiograph) taken by Röntgen An X-ray is a form of electromagnetic radiation with a wavelength approximately in the range of 5 pm to 10 nanometers (corresponding to frequencies in the range 30 PHz... For other uses, see Ultrasound (disambiguation). ...


Another sign of Graves' disease is hyperthyroidism, i.e. over-production of the thyroid hormones T3 and T4. Although, hypothyroidism has also been associated (and may be the cause, in some patients). Hyperthyroidism can be confirmed by measuring elevated blood levels of free (unbound) T3 and T4. Other useful laboratory measurements include thyroid-stimulating hormone (TSH, low in Graves' disease due to negative feedback from the elevated T3 and T4), and protein-bound iodine (elevated). Thyroid-stimulating antibodies may also be detected serologically. Hyperthyroidism (or overactive thyroid gland) is the clinical syndrome caused by an excess of circulating free thyroxine (T4) or free triiodothyronine (T3), or both. ... The thyroid hormones, thyroxine (T4) and triiodothyronine (T3), are tyrosine-based hormones produced by the thyroid gland. ... This article or section does not cite its references or sources. ... Thyroid-stimulating hormone (also known as TSH or thyrotropin) is a hormone synthesized and secreted by thyrotrope cells in the anterior pituitary gland which regulates the endocrine function of the thyroid gland. ... This article does not cite any references or sources. ... For other uses, see Iodine (disambiguation). ... Serology is the scientific study of blood serum. ...


Biopsy to obtain histiological testing is not normally required, but may be obtained if thyroidectomy is performed. Brain biopsy A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ...


Differentiating two common forms of hyperthyroidism such as Graves disease and Toxic Multinodular Goiter is important to determine proper treatment. Measuring TSH-receptor antibodies with the h-TBII assay has been proven efficient and the most practical approach presented in a study.[7]


Eye disease

Thyroid-associated ophthalmopathy is one of the most typical symptom of Graves' disease. It is known by a variety of terms, the most common being Graves' ophthalmopathy. Thyroid eye disease is an inflammatory condition which affects the orbital contents including the extraocular muscles and orbital fat. It is almost always associated with Graves' disease but may rarely be seen in Hashimoto's thyroiditis, primary hypothyroidism, or thyroid cancer. The extraocular muscles are the six muscles that control the movements of the eye. ... Hashimotos thyroiditis or chronic lymphocytic thyroiditis is an autoimmune disease where the bodys own antibodies attack the cells of the thyroid. ... This article or section does not cite its references or sources. ... Thyroid cancer is malignant growth of the thyroid gland. ...


The ocular manifestations include soft tissue inflammation, eyelid retraction, proptosis, corneal exposure, and optic nerve compression. The signs and symptoms of the disease are characteristic. These include lid retraction, lid lag, and a delay in the downward excursion of the upper eyelid in down gaze that is specific to thyroid-associated ophthalmopathy. The cornea is the transparent front part of the eye that covers the iris, pupil, and anterior chamber, providing most of an eyes optical power [1]. Together with the lens, the cornea refracts light and, as a result, helps the eye to focus. ... This article is about the anatomical structure. ...

  • For mild disease - artificial tears, steroid eyedrops, oral steroids (to reduce chemosis)
  • For moderate disease - lateral tarsorrhaphy
  • For severe disease - orbital decompression or retro-orbital radiation

Artificial tears are used to treat the dryness and irritation caused by reduced tear flow. ... Ñ…Ã’Chemosis is swelling (or edema) of the conjunctiva. ... Tarsorrhaphy is a surgical procedure in which the eyelids are partially sewn together to narrow the opening. ...

Other Graves' disease symptoms

Some of the most typical symptoms of Graves' Disease may include the following:

  • Palpitations
  • Tachycardia (rapid heart rate: 100-120 beats per minute, or higher)
  • Arrhythmia (irregular heart beat)
  • Raised blood pressure (Hypertension)
  • Tremor (usually fine shaking e.g. hands)
  • Excessive sweating
  • Heat intolerance
  • Increased appetite
  • Unexplained weight loss despite increased appetite
  • Shortness of breath
  • Muscle weakness (especially in the large muscles of the arms and legs) and degeneration
  • Diminished/changed sex drive
  • Insomnia (inability to get enough sleep)
  • Increased energy
  • Fatigue
  • Mental impairment, memory lapses, diminished attention span
  • Decreased concentration
  • Nervousness, agitation
  • Irritability
  • Restlessness
  • Erratic behavior
  • Emotional lability
  • Brittle nails
  • Abnormal breast enlargement (men)
  • Goiter (enlarged thyroid gland)
  • Protruding eyeballs
  • Double vision
  • Eye pain, irritation, tingling sensation behind the eyes or the feeling of grit or sand in the eyes
  • Swelling or redness of eyes or eyelids/eyelid retraction
  • Sensitivity to light
  • Decrease in menstrual periods (oligomenorrhea), Irregular and scant menstrual flow (Amenorrhea)
  • Difficulty conceiving/infertility/recurrent miscarriage
  • Hair loss
  • Itchy skin, hives
  • Chronic sinus infections
  • Lumpy, reddish skin of the lower legs (pretibial myxedema)
  • Smooth, velvety skin
  • Increased bowel movements or Diarrhea
  • Sometimes dizziness occurs

Incidence and epidemiology

The disease occurs most frequently in women (7:1 compared to men). It occurs most often in middle age (most commonly in the third to fifth decades of life), but is not uncommon in adolescents, during pregnancy, at the time of menopause and in people over age 50. There is a marked family preponderance, which has led to speculation that there may be a genetic component. To date, no clear genetic defect has been found that would point at a monogenic cause. Image File history File links No higher resolution available. ... Image File history File links No higher resolution available. ... In genetics, monogenic genetic disorders are hereditary diseases that result from abnormalities in one (mono) gene. ...


Pathophysiology

Graves' disease is an autoimmune disorder, in which the body produces antibodies to the receptor for thyroid-stimulating hormone (TSH). (Antibodies to thyroglobulin and to the thyroid hormones T3 and T4 may also be produced.) Autoimmunity is the failure of an organism to recognize its own constituent parts (down to the sub-molecular levels) as self, which results in an immune response against its own cells and tissues. ... Each antibody binds to a specific antigen; an interaction similar to a lock and key. ... The thyrotropin receptor (or TSH receptor) is a gene (and associated protein) which responds to thyroid-stimulating hormone (also known as thyrotropin, and stimulates the production of thyroxine (T4) and triiodothyronine (T3). ... The thyroid hormones, thyroxine (T4) and triiodothyronine (T3), are tyrosine-based hormones produced by the thyroid gland. ...


These antibodies cause hyperthyroidism because they bind to the TSH receptor and chronically stimulate it. The TSH receptor is expressed on the follicular cells of the thyroid gland (the cells that produce thyroid hormone), and the result of chronic stimulation is an abnormally high production of T3 and T4. This in turn causes the clinical symptoms of hyperthyroidism, and the enlargement of the thyroid gland visible as goiter. Hyperthyroidism (or overactive thyroid gland) is the clinical syndrome caused by an excess of circulating free thyroxine (T4) or free triiodothyronine (T3), or both. ... In medicine, a chronic disease is a disease that is long-lasting or recurrent. ... Section of thyroid gland of sheep. ... Hyperthyroidism (or overactive thyroid gland) is the clinical syndrome caused by an excess of circulating free thyroxine (T4) or free triiodothyronine (T3), or both. ... A goitre (BrE), or goiter (AmE) (Latin struma), also called a bronchocele, is a swelling in the neck (just below Adams apple or larynx) due to an enlarged thyroid gland. ...


The infiltrative exophthalmos that is frequently encountered has been explained by postulating that the thyroid gland and the extraocular muscles share a common antigen which is recognized by the antibodies. Antibodies binding to the extraocular muscles would cause swelling behind the eyeball. Exophthalmos (or proptosis) is a bulging of the eye anteriorly out of the orbit. ...


The "orange peel" skin has been explained by the infiltration of antibodies under the skin, causing an inflammatory reaction and subsequent fibrous plaques.


There are 3 types of autoantibodies to the TSH receptor currently recognized:

  • TSI, Thyroid stimulating immunoglobulins: these antibodies (mainly IgG) act as LATS (Long Acting Thyroid Stimulants), activating the cells in a longer and slower way than TSH, leading to an elevated production of thyroid hormone.
  • TGI, Thyroid growth immunoglobulins: these antibodies bind directly to the TSH receptor and have been implicated in the growth of thyroid follicles.
  • TBII, Thyrotrophin Binding-Inhibiting Immunoglobulins: these antibodies inhibit the normal union of TSH with its receptor. Some will actually act as if TSH itself is binding to its receptor, thus inducing thyroid function. Other types may not stimulate the thyroid gland, but will prevent TSI and TSH from binding to and stimulating the receptor.

Etiology

The trigger for auto-antibody production is not known. There appears to be a genetic predisposition for Graves' disease, suggesting that some people are more prone than others to develop TSH receptor activating antibodies due to a genetic cause. HLA DR (especially DR3) appears to play a significant role.[8] This article is about the general scientific term. ... HLA region of Chromosome 6 The human leukocyte antigen system (HLA) is the name of the human major histocompatibility complex (MHC). ...


Since Graves' disease is an autoimmune disease which appears suddenly, often quite late in life, it is thought that a viral or bacterial infection may trigger antibodies which cross-react with the human TSH receptor (a phenomenon known as antigenic mimicry, also seen in some cases of type I diabetes). This article is about biological infectious particles. ... Phyla Actinobacteria Aquificae Chlamydiae Bacteroidetes/Chlorobi Chloroflexi Chrysiogenetes Cyanobacteria Deferribacteres Deinococcus-Thermus Dictyoglomi Fibrobacteres/Acidobacteria Firmicutes Fusobacteria Gemmatimonadetes Lentisphaerae Nitrospirae Planctomycetes Proteobacteria Spirochaetes Thermodesulfobacteria Thermomicrobia Thermotogae Verrucomicrobia Bacteria (singular: bacterium) are unicellular microorganisms. ... See also molecular mimicry This term describes a phenomenon encountered in diseases of the immune system, where the immune system cross-reacts to antigens from different sources. ... This article is about the disease that features high blood sugar. ...


One possible culprit is the bacterium Yersinia enterocolitica (a cousin of Yersinia pestis, the agent of bubonic plague). However, although there is indirect evidence for the structural similarity between the bacteria and the human thyrotropin receptor, direct causative evidence is limited.[8] Yersinia seems not to be a major cause of this disease, although it may contribute to the development of thyroid autoimmunity arising for other reasons in genetically susceptible individuals.[9] It has also been suggested that Y. enterocolitica infection is not the cause of auto-immune thyroid disease, but rather is only an associated condition; with both having a shared inherited susceptibility.[10] More recently the role for Y. enterocolitica has been disputed.[11] Binomial name Yersinia enterocolitica (Schleifstein & Coleman 1939) Yersinia enterocolitica is a species of gram-negative coccobacillus-shaped bacterium, belonging to the family Enterobacteriaceae. ... Binomial name (Lehmann & Neumann, 1896) van Loghem 1944 Yersinia pestis (Pasteurella pestis) is a Gram-negative facultative anaerobic bipolar-staining (giving it a safety pin appearance) bacillus bacterium belonging to the family Enterobacteriaceae. ... In statistics, an association (statistics) comes from two variables who are related. ...


The ocular manifestations of Graves' disease are more common in smokers and tend to worsen (or develop for the first time) following radioiodine treatment of the thyroid condition. Thus, they are not caused by hyperthyroidism per se; this common misperception may result from the fact that hyperthyroidism from other causes may cause eyelid retraction or eyelid lag (so-called hyperthyroid stare) which can be confused with the general appearance of proptosis/exophthalmos, despite the fact that the globes do not actually protrude in other causes of hyperthyroidism. Also, both conditions (globe protrusion and hyperthyroid lid retraction) may exist at the same time in the hyperthyroid patient with Graves' disease.


Treatment

Treatment of Graves' disease includes antithyroid drugs which reduce the production of thyroid hormone, radioiodine (radioactive iodine I131), and thyroidectomy (surgical excision of the gland). As operating on a frankly hyperthyroid patient is dangerous, prior to thyroidectomy preoperative treatment with antithyroid drugs is given to render the patient "euthyroid" (i.e. normothyroid). The thyroid hormones, thyroxine (T4) and triiodothyronine (T3), are tyrosine-based hormones produced by the thyroid gland. ... Radioiodine is the common name for iodine-131, a radioisotope of iodine. ... For other uses, see Iodine (disambiguation). ... A thyroidectomy involves the surgical removal all or part of the thyroid gland. ...


Treatment with antithyroid medications must be given for six months to two years, in order to be effective. Even then, upon cessation of the drugs, the hyperthyroid state may recur. Side effects of the antithyroid medications include a potentially fatal reduction in the level of white blood cells. The development and widespread adoption of radioiodine treatment has led to a progressive reduction in the use of surgical thyroidectomy for this problem. In general, RAI therapy is effective, less expensive, and avoids the small but definite risks of surgery.


Therapy with radioiodine is the most common treatment in the United States, whilst antithyroid drugs and/or thyroidectomy is used more often in Europe, Japan, and most of the rest of the world.


Antithyroid drugs

The main antithyroid drugs are carbimazole (UK), methimazole (US), and propylthiouracil (PTU). These drugs block the binding of iodine and coupling of iodotyrosines. The most dangerous side-effect is agranulocytosis (1/250, more in PTU); this is an idiosyncratic reaction which does not stop on cessation of drug. Others include granulocytopenia (dose dependent, which improves on cessation of the drug) and aplastic anemia. Patients on these medications should see a doctor if they develop sore throat or fever. The most common side effects are rash and peripheral neuritis. These drugs also cross the placenta and are secreted in breast milk. Lygole is used to block hormone synthesis before surgery. Carbimazole is used to treat hyperthyroidism. ... Methimazole is an antithyroid drug similar in action to propylthiouracil. ... Propylthiouracil is a thioamide drug used to treat hyperthyroidism. ... Neutropenia (or neutropaenia, adjective neutrop(a)enic) is a hematological disorder characterized by an abnormally low number of neutrophil granulocytes (a type of white blood cell). ... Aplastic anemia is a condition where bone marrow does not produce sufficient new cells to replenish blood cells. ... The placenta (Latin for cake, referencing its appearance in humans) is an ephemeral organ present in placental vertebrates, such as eutherial mammals and sharks during gestation (pregnancy). ...


A randomized control trial testing single dose treatment for Graves found methimazole achieved euthyroid state more effectively after 12 weeks that did propylthyouracil (77.1% on methimazole 15 mg vs 19.4% in the propylthiouracil 150 mg groups).[12] A randomized controlled trial (RCT) is a form of clinical trial, or scientific procedure used in the testing of the efficacy of medicines or medical procedures. ...


A study has shown no difference in outcome for adding thyroxine to antithyroid medication and continuing thyroxine versus placebo after antithyroid medication withdrawal. However two markers were found that can help predict the risk of recurrence. These two markers are a positive Thyroid Stimulating Hormone receptor antibody (TSHR-Ab) and smoking. A positive TSHR-Ab at the end of antithyroid drug treatment increases the risk of recurrence to 90% (sensitivity 39%, specificity 98%), a negative TSHR-Ab at the end of antithyroid drug treatment is associated with a 78% chance of remaining in remission. Smoking was shown to have an impact independent to a positive TSHR-Ab.[13] The thyrotropin receptor (or TSH receptor) is a gene (and associated protein) which responds to thyroid-stimulating hormone (also known as thyrotropin, and stimulates the production of thyroxine (T4) and triiodothyronine (T3). ... Each antibody binds to a specific antigen; an interaction similar to a lock and key. ... See: Sensitivity (electronics) Sensitivity (human) Sensitivity (tests) For sensitivity in finance, see beta coefficient This is a disambiguation page — a navigational aid which lists other pages that might otherwise share the same title. ... In binary testing, e. ...


Radioiodine

Radioiodine (radioactive iodine I-131) was developed in the early 1940s at the Mallinckrodt General Clinical Research Center. This modality is suitable for most patients, although some prefer to use it mainly for older patients. Indications for radioiodine are: failed medical therapy or surgery and where medical or surgical therapy are contraindicated. Hypothyroidism could be a complication of this therapy. Radioiodine is the common name for iodine-131, a radioisotope of iodine. ... The Mallinckrodt MGH General Clinical Research Center (GCRC) is a research center at Massachusetts General Hospital. ... Radioiodine is the common name for iodine-131, a radioisotope of iodine. ...


Contraindications to RAI are pregnancy (absolute), ophthalmopathy (relative; it can aggravate thyroid eye disease), solitary nodules. Disadvantages of this treatment are a high incidence of hypothyroidism (up to 80%) requiring hormone supplementation. It acts slowly and has a relapse rate that depends on the dose administered. This article is about human pregnancy in biological females. ... A thyroid nodule is a swelling that develops in the thyroid gland. ... This article or section does not cite its references or sources. ...


Surgery

This modality is suitable for young patients and pregnant patients. Indications are: a large goiter (especially when compressing the trachea), suspicious nodules or suspected cancer (to pathologically examine the thyroid) and patients with ophthalmopathy. Windpipe redirects here. ... Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ...


Both bilateral subtotal thyroidectomy and the Hartley-Dunhill procedure (hemithyroidectomy on 1 side and partial lobectomy on other side) are possible.


Advantages are: immediate cure and potential removal of carcinoma. Its risks are injury of the recurrent laryngeal nerve, hypoparathyroidism (due to removal of the parathyroid glands), hematoma (which can be life-threatening if it compresses the trachea) and scarring. In medicine, carcinoma is any cancer that arises from epithelial cells. ... The recurrent laryngeal nerve is a branch of the vagus nerve (the tenth cranial nerve) that supplies motor function and sensation to the larynx (voice box). ... In medicine (endocrinology), hypoparathyroidism is decreased function of the parathyroid glands, leading to decreased levels of parathyroid hormone (PTH). ... The four human parathyroid glands are adjacent to the thyroid. ... Hematoma on thigh, 6 days after a fall down stairs, 150ml of blood drained a few days later A hematoma, or haematoma, is a collection of blood, generally the result of hemorrhage, or, more specifically, internal bleeding. ... A scar results from the biologic process of wound repair in the skin and other tissues of the body. ...


No treatment

If left untreated, more serious complications could result, including birth defects in pregnancy, increased risk of a miscarriage, and in extreme cases, death. Graves-Basedow disease is often accompanied by an increase in heart rate, which may lead to further heart complications including loss of the normal heart rhythm (atrial fibrillation), which may lead to stroke. If the eyes are proptotic (bulging) severely enough that the lids do not close completely at night, severe dryness will occur with a very high risk of a secondary corneal infection which could lead to blindness. Pressure on the optic nerve behind the globe can lead to visual field defects and vision loss as well. Complication, in medicine, is a unfavorable evolution of a disease, a health condition or a medical treatment. ... A congenital disorder is a medical condition or defect that is present at or before birth (for example, congenital heart disease). ... Miscarriage or spontaneous abortion is the natural or spontaneous end of a pregnancy at a stage where the embryo or the fetus is incapable of surviving, generally defined in humans at a gestation of prior to 20 weeks. ...


Symptoms treatment

β-blockers (such as propranolol) may be used to inhibit the sympathetic nervous system symptoms of tachycardia and nausea until such time as antithyroid treatments start to take effect. Beta blockers or beta-adrenergic blocking agents are a class of drugs used to treat a variety of cardiovascular conditions and some other diseases. ... Propranolol (INN) (IPA: ) is a non-selective beta blocker mainly used in the treatment of hypertension. ... The Sympathetic Nervous System (SNS) is a branch of the autonomic nervous system. ... This article or section does not cite any references or sources. ...


Noted sufferers

  • United States President George H. W. Bush developed new atrial fibrillation and was diagnosed in 1991 with hyperthyroidism due to the disease and was treated at Walter Reed Army Medical Center with radioactive iodine. By coincidence (or so it is presumed, since the ultimate cause of this disease remains unknown), the president's wife, Barbara Bush, and the Bushes' pet dog, a springer spaniel named Millie, also developed the disease about the same time, which in Barbara's case produced severe infiltrative exophthalmos and a cosmetic change in the appearance of her eyes.
  • Canadian Minister of Citizenship and Immigration Diane Finley announced in the House of Commons that she was suffering from the disease. She now wears sunglasses to protect her eyes from the bright lighting in the chamber.
  • Nadezhda Krupskaya (1869-1939), wife of Vladimir Lenin, was believed to have suffered from the disease, which caused her eyes to bulge and her neck to tighten. This was the reason that her Bolshevik codename was 'Fish.' Since Graves' disease disrupts the menstrual cycle, it is believed that this is why the couple never had children.
  • Bobby Engram, NFL wide receiver with the Seattle Seahawks (diagnosed October 2006).
  • German folk singer and musician Heino, who has since become famous for his wearing of dark sunglasses to protect his eyes from bright sunlight.
  • English composer Herbert Howells was diagnosed with the disease in 1915 and given six months to live but made a recovery after undergoing experimental radium treatment and went on to live to the age of ninety.
  • British actress Maggie Smith came down with the disease but recovered swiftly due to close help from her son.
  • 2000 NASCAR NEXTEL Cup Champion Bobby Labonte was diagnosed with the disease in 1995.
  • Marty Feldman, English writer, comedian and film and television actor. The illness affected the appearance of his eyes, which bulged noticeably.
  • Christina Rossetti, English poet, was diagnosed in 1893 and died a year later. Whether or not the death and disease is connected has been left undetermined.
  • Second President of the United States, John Adams, is believed to have suffered from Graves' disease. This may have accounted for his irritability and erratic habits and writings.
  • Olympian runner Gail Devers was diagnosed in 1988.
  • Japanese voice actress Yuko Miyamura (most famous for her role voicing Evangelion Pilot Asuka Langley Soryu) was diagnosed in 2007 after suffering exophthalmos. [1]
  • Martin Krugman a.k.a. "Marty," an associate of the Lucchese crime family and the basis for the character "Morrie Kessler" in the movie Goodfellas, suffered from Graves' disease.

George Herbert Walker Bush (born June 12, 1924) was the 41st President of the United States, serving from 1989 to 1993. ... Atrial fibrillation (AF or afib) is a cardiac arrhythmia (abnormal heart rhythm) that involves the two upper chambers (atria) of the heart. ... White House Portrait Barbara Pierce Bush (born June 8, 1925) is the wife of the 41st President of the United States, George H. W. Bush, and was First Lady of the United States from 1989 to 1993. ... Hon. ... Diane Finley PC, MP (born October 3, 1958 in Hamilton, Ontario) is a Canadian politician. ... Type Lower House Speaker Peter Milliken, Liberal since January 29, 2001 Leader of the Government in the House of Commons Peter Van Loan, Conservative since January 4, 2007 Opposition House Leader Ralph Goodale, Liberal since January 23, 2006 Members 308 Political groups Conservative Party Liberal Party Bloc Québécois... Nadezhda Krupskaya Nadezhda K. Krupskaya ( February 26, 1869 - February 27, 1939) was a Russian Marxist revolutionary. ... Lenin redirects here. ... For other uses, see Bolshevik (disambiguation). ... Bobby Engram (born January 7, 1973, Camden, South Carolina) is an American football wide receiver who currently plays for the Seattle Seahawks. ... NFL logo For other uses of the abbreviation NFL, see NFL (disambiguation). ... The wide receiver (WR) position in American and Canadian football is the pass-catching specialist. ... City Seattle, Washington Team colors Pacific Blue, Navy Blue, Neon Green, White Head Coach Mike Holmgren Owner Paul Allen General manager Tim Ruskell Mascot Blitz, and Taima the hawk League/Conference affiliations National Football League (1976–present) American Football Conference (1977-2001) AFC West (1977-2001) National Football Conference (1976... The one and only Heino! Heino (born December 13, 1938 Düsseldorf as Heinz Georg Kramm) is a German singer of popular music (Schlager and Volksmusik). ... A composer is a person who writes music. ... Herbert Norman Howells CH (17 October 1892 – 23 February 1983) was an English composer, organist, and teacher. ... Dame Margaret Natalie Smith, DBE (born 28 December 1934), better known as Dame Maggie Smith, is a two-time Academy Award, and Emmy-winning English film, stage, and television actress. ... Jeff Burton (99), Elliott Sadler (38), Ricky Rudd (21), Dale Jarrett (88), Sterling Marlin (40), Jimmie Johnson (48), and Casey Mears (41) practice for the 2004 Daytona 500 The National Association for Stock Car Auto Racing (NASCAR) is the largest sanctioning body of motorsports in the United States. ... The NEXTEL Cup Series is NASCARs top racing series. ... Robert Alan Labonte (born May 8, 1964) is an American race car driver and drives the #43 Cheerios Dodge Charger for the Petty Enterprises NASCAR Racing Team in the Nextel Cup Series and the #77 Dollar General Chevrolet Monte Carlo for Kevin Harvick Incorporated in the Busch Series. ... Martin Alan Marty Feldman (8 July 1934[1] – 2 December 1982) was an English writer, comedian and BAFTA award winning actor, notable for his bulging eyes, which were the result of a thyroid condition known as Graves Disease. ... Christina Rossetti Christina Georgina Rossetti (December 5, 1830 – December 29, 1894) was an English poet. ... For other persons named John Adams, see John Adams (disambiguation). ... Yolanda Gail Devers (born November 19, 1966 in Seattle, Washington, USA) is a three-time Olympic 100 m champion in athletics for the US Olympic Team. ... Yuko Miyamura (宮村 優子 Miyamura YÅ«ko) (born December 4, 1972) is a Japanese seiyÅ«, J-pop singer and sound director. ... Asuka Langley Soryu ) is a 14 year old[2] fictional character and one of the three primary protagonists from the anime and manga Neon Genesis Evangelion and the movies Evangelion: Death and Rebirth and The End of Evangelion. ... Exophthalmos (or proptosis) is a bulging of the eye anteriorly out of the orbit. ... Martin Marty Krugman. ... The Lucchese crime family is one of the Five Families that controls organized crime activities in New York City, USA, within the nationwide criminal phenomenon known as the Mafia (or Cosa Nostra). ... Goodfellas (also spelled GoodFellas) is an Academy Award winning 1990 crime drama film directed by Martin Scorsese, based on the book Wiseguy by Nicholas Pileggi, the true story of mob informer Henry Hill. ...

Bibliography

  • Sayyid Ismail Al-Jurjani. Thesaurus of the Shah of Khwarazm.
  • Flajani, G. Sopra un tumor freddo nell'anterior parte del collo broncocele. (Osservazione LXVII). In Collezione d'osservazioni e reflessioni di chirurgia. Rome, Michele A Ripa Presso Lino Contedini, 1802;3:270-273.
  • Testa, AG. Delle malattie del cuore, loro cagioni, specie, segni e cura. Bologna, 1810. 2nd edition in 3 volumes, Florence, 1823; Milano 1831; German translation, Halle, 1813.
  • Parry, CH. Enlargement of the thyroid gland in connection with enlargement or palpitations of the heart. Posthumous, in: Collections from the unpublished medical writings of C. H. Parry. London, 1825, pp. 111-129. According to Garrison, Parry first noted the condition in 1786. He briefly reported it in his Elements of Pathology and Therapeutics, 1815. Reprinted in Medical Classics, 1940, 5: 8-30.
  • Graves, RJ. New observed affection of the thyroid gland in females. (Clinical lectures.) London Medical and Surgical Journal (Renshaw), 1835; 7: 516-517. Reprinted in Medical Classics, 1940;5:33-36.
  • Marsh, H. Dilatation of the cavities of the heart. Enlargement of the thyroid gland. Dublin Journal of Medical and Chemical Science. 1842, 20: 471-474. Abstract.
  • Von Basedow, KA. Exophthalmus durch Hypertrophie des Zellgewebes in der Augenhöhle. [Casper's] Wochenschrift für die gesammte Heilkunde, Berlin, 1840, 6: 197-204; 220-228. Partial English translation in: Ralph Hermon Major (1884-1970): Classic Descriptions of Disease. Springfield, C. C. Thomas, 1932. 2nd edition, 1939; 3rd edition, 1945.
  • Von Basedow, KA. Die Glotzaugen. [Casper's] Wochenschrift für die gesammte Heilkunde, Berlin, 1848: 769-777.
  • Begbie, J. Anaemia and its consequences; enlargement of the thyroid gland and eyeballs. Anaemia and goitre, are they related? Monthly Journal of Medical Science, London, 1849, 9: 496-508.

References

  1. ^ Robert James Graves at Who Named It
  2. ^ a b Basedow's syndrome or disease at Who Named It - the history and naming of the disease
  3. ^ Goiter, Diffuse Toxic at eMedicine
  4. ^ Giuseppe Flajani at Who Named It
  5. ^ Hull G (1998). "Caleb Hillier Parry 1755-1822: a notable provincial physician". Journal of the Royal Society of Medicine 91 (6): 335-8. PMID 9771526. 
  6. ^ Caleb Hillier Parry at Who Named It
  7. ^ Wallaschofski H, Kuwert T, Lohmann T(2004). “TSH-receptor autoantibodies-differentiation of hyperthyroidism between Graves’ disease and toxic multinodular goiter." Experimental and clinical endocrinology and diabetes 112 (4):171-4 [PMID 15127319]
  8. ^ a b Tomer Y, Davies T (1993). "Infection, thyroid disease, and autoimmunity." (PDF). Endocr Rev 14 (1): 107-20. PMID 8491150. 
  9. ^ Toivanen P, Toivanen A (1994). "Does Yersinia induce autoimmunity?". Int Arch Allergy Immunol 104 (2): 107-11. PMID 8199453. 
  10. ^ Strieder T, Wenzel B, Prummel M, Tijssen J, Wiersinga W (2003). "Increased prevalence of antibodies to enteropathogenic Yersinia enterocolitica virulence proteins in relatives of patients with autoimmune thyroid disease.". Clin Exp Immunol 132 (2): 278-82. PMID 12699417. 
  11. ^ Hansen P, Wenzel B, Brix T, Hegedüs L (2006). "Yersinia enterocolitica infection does not confer an increased risk of thyroid antibodies: evidence from a Danish twin study.". Clin Exp Immunol 146 (1): 32-8. PMID 16968395. 
  12. ^ Homsanit M, Sriussadaporn S, Vannasaeng S, Peerapatdit T, Nitiyanant W, Vichayanrat A (2001). "Efficacy of single daily dosage of methimazole vs. propylthiouracil in the induction of euthyroidism". Clin. Endocrinol. (Oxf) 54 (3): 385-90. PMID 11298092. 
  13. ^ Glinoer D, de Nayer P, Bex M (2001). "Effects of l-thyroxine administration, TSH-receptor antibodies and smoking on the risk of recurrence in Graves' hyperthyroidism treated with antithyroid drugs: a double-blind prospective randomized study". Eur. J. Endocrinol. 144 (5): 475-83. PMID 11331213. 

Who Named It is a Norwegian database of several thousand eponymous medical signs and the doctors associated with their identification. ... Who Named It is a Norwegian database of several thousand eponymous medical signs and the doctors associated with their identification. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Who Named It is a Norwegian database of several thousand eponymous medical signs and the doctors associated with their identification. ... Who Named It is a Norwegian database of several thousand eponymous medical signs and the doctors associated with their identification. ...

See also

Levothyroxine, also known as L-thyroxine, synthetic T4 or 3,5,3,5-tetraiodo-L-thyronine, is a synthetic form of thyroxine (thyroid hormone). ...

External links

  • Alternative Health Solutions for Thyroid Autoimmunity Graves' and Hashimoto's disease resource site
  • Minimal access thyroid surgery for Graves' disease discussed by a UK specialist surgeon
  • MedifocusHealth.com guidebook on Graves' disease based on medical literature.
  • Compilation of basic information and self help strategies for those suffering from Graves' disease.
  • Video of the histopathology of Graves' disease.


Endocrinology is a branch of medicine dealing with disorders of the endocrine system and its specific secretions called hormones. ... A renal cell carcinoma (chromophobe type) viewed on a hematoxylin & eosin stained slide Pathologist redirects here. ... Among the hundreds of endocrine diseases (or endocrinological diseases) are: Adrenal disorders: Adrenal insufficiency Addisons disease Congenital adrenal hyperplasia (adrenogenital syndrome) Mineralocorticoid deficiency Conns syndrome Cushings syndrome Pheochromocytoma Adrenocortical carcinoma Glucose homeostasis disorders: Diabetes mellitus Hypoglycemia Idiopathic hypoglycemia Insulinoma Metabolic bone disease: Osteoporosis Osteitis deformans (Pagets... This article or section does not cite its references or sources. ... This article does not cite any references or sources. ... This article is about the medical term. ... Congenital hypothyroidism (CHT) is a condition of thyroid hormone deficiency present at birth. ... A goitre (BrE), or goiter (AmE) (Latin struma), also called a bronchocele, is a swelling in the neck (just below Adams apple or larynx) due to an enlarged thyroid gland. ... Myxedema (English: myxoedema) is a skin and tissue disorder usually due to severe prolonged hypothyroidism. ... Hyperthyroidism (or overactive thyroid gland) is the clinical syndrome caused by an excess of circulating free thyroxine (T4) or free triiodothyronine (T3), or both. ... Graves disease is a thyroid disorder characterized by goiter, exophthalmos, orange-peel skin, and hyperthyroidism. ... Toxic multinodular goitre (also known as toxic nodular goitre, toxic nodular struma) is a form of hyperthyroidism - where there is excess production of thyroid hormones. ... Look up teratoma in Wiktionary, the free dictionary. ... A teratoma is a type of tumor that derives from pluripotent germ cells. ... de Quervains thyroiditis, is also known as subacute granulomatous thyroiditis or subacute thyroiditis; usually occurs in women between 30 and 50 years of age. ... Hashimotos thyroiditis or chronic lymphocytic thyroiditis is an autoimmune disease where the bodys own antibodies attack the cells of the thyroid. ... Riedels thyroiditis, also called Riedels struma is a chronic form of thyroiditis. ... Euthyroid sick syndrome is a thyroid hormone disorder where the levels of T3 and/or T4 are at unusual levels, but the thyroid gland does not appear to be dysfunctional. ... The pancreas is a gland organ in the digestive and endocrine systems of vertebrates. ... For the disease characterized by excretion of large amounts of very dilute urine, see diabetes insipidus. ... Diabetes mellitus type 1 (Type 1 diabetes, Type I diabetes, T1D, T1DM, IDDM, juvenile diabetes) is a form of diabetes mellitus. ... Diabetes mellitus type 2 or Type 2 Diabetes (formerly called non-insulin-dependent diabetes (NIDDM), obesity-related diabetes, or adult-onset diabetes) is a metabolic disorder that is primarily characterized by insulin resistance, relative insulin deficiency, and hyperglycemia. ... Diabetic coma is a medical emergency in which a person with diabetes mellitus is comatose (unconscious) because of one of three acute complications of diabetes: Severe diabetic hypoglycemia Advanced diabetic ketoacidosis advanced enough to result in unconsciousness from a combination of severe hyperglycemia, dehydration and shock, and exhaustion Hyperosmolar nonketotic... Angiopathy is a disease of the blood vessels (arteries, veins, and capillaries) that occurs when someone has diabetes for a long time. ... Diabetic ketoacidosis(DKA) is a life-threatening complication in patients with untreated diabetes mellitus (chronic high blood sugar or hyperglycemia). ... Diabetic nephropathy (nephropatia diabetica), also known as Kimmelstiel-Wilson syndrome and intercapillary glomerulonephritis, is a progressive kidney disease caused by angiopathy of capillaries in the kidney glomeruli. ... Diabetic neuropathies are neuropathic disorders that are associated with diabetes mellitus. ... Diabetic retinopathy is retinopathy (damage to the retina) caused by complications of diabetes mellitus, which could eventually lead to blindness. ... Hypoglycemia (hypoglycaemia in British English) is a medical term referring to a pathologic state produced by a lower than normal level of glucose (sugar) in the blood. ... Hyperinsulism or hyperinsulinemia is a condition in which the bodys cells do not respond properly to insulin, the hormone that functions to control blood sugar levels. ... Zollinger-Ellison syndrome is a disorder where increased levels of the hormone gastrin are produced, causing the stomach to produce excess hydrochloric acid. ... The four human parathyroid glands are adjacent to the thyroid. ... In medicine (endocrinology), hypoparathyroidism is decreased function of the parathyroid glands, leading to decreased levels of parathyroid hormone (PTH). ... Pseudohypoparathyroidism is a condition that mimics hypoparathyroidism, but is due to a resistance to parathyroid hormone, rather than a lack of the hormone (akin to the distinction between Type 1 diabetes and Type 2 diabetes. ... Hyperparathyroidism is overactivity of the parathyroid glands resulting in excess production of parathyroid hormone (PTH). ... Primary hyperparathyroidism causes hypercalcemia (elevated blood calcium levels) through the excessive secretion of parathyroid hormone (PTH), usually by an adenoma (benign tumors) of the parathyroid glands. ... Secondary hyperparathyroidism refers to the excessive secretion of parathyroid hormone (PTH) by the parathyroid glands in response to hypocalcemia (low blood calcium levels) and associated hypertrophy of the glands. ... Tertiary hyperparathyroidism is a state of excessive secretion of parathyroid hormone (PTH) after a long period of secondary hyperparathyroidism and resulting in hypercalcemia. ... | Latin = hypophysis, glandula pituitaria | GraySubject = 275 | GrayPage = 1275 | Image = Gray1180. ... Hyperpituitarism is the result of an overactive pituitary gland producing too much of the bodies natural growth hormones. ... Acromegaly (from Greek akros high and megas large - extremities enlargement) is a hormonal disorder that results when the pituitary gland produces excess growth hormone (hGH). ... Prolactin is a hormone secreted by lactotropes in the adenohypophysis (anterior pituitary gland) which is made up of 199 amino acids with a molecular weight of about 23,000 daltons. ... The syndrome of inappropriate antidiuretic hormone (SIADH) is a condition commonly found in the hospital population, especially in patients being hospitalized for central nervous system (CNS) injury. ... Hypopituitarism is a medical term describing deficiency (hypo) of one or more hormones of the pituitary gland. ... Simmonds disease (also Simmonds syndrome) refers to panhypopituitarism caused by the destruction of the pituitary gland due to infiltrative processes (e. ... Sheehan syndrome, also known as postpartum hypopituitarism or postpartum pituitary necrosis, is hypopituitarism (decreased functioning of the pituitary gland), caused by necrosis due to blood loss and hypovolemic shock during and after childbirth. ... Kallmann syndrome is an example of hypogonadism (decreased functioning of the sex hormone-producing glands) caused by a deficiency of gonadotropin-releasing hormone (GnRH), which is created by the hypothalamus. ... Growth Hormone Deficiency is the medical condition of inadequate production of growth hormone (GH) and its effects on children and adults. ... Diabetes insipidus (DI) is a disease characterized by excretion of large amounts of severely diluted urine, which cannot be reduced when fluid intake is reduced. ... Adiposogenital dystrophy is a medical condition. ... Empty sella syndrome (abbreviated ESS) is a disorder that involves the sella turcica, a bony structure at the base of the brain that surrounds and protects the pituitary gland. ... In mammals, the adrenal glands (also known as suprarenal glands) are the triangle-shaped endocrine glands that sit on top of the kidneys; their name indicates that position (ad-, near or at + -renes, kidneys). They are chiefly responsible for regulating the stress response through the synthesis of corticosteroids and catecholamines... Wikipedia does not have an article with this exact name. ... Pseudo-Cushings syndrome is a medical condition in which patients display the signs, symptoms, and abnormal hormone levels seen in Cushings syndrome. ... Congenital adrenal hyperplasia (CAH) refers to any of several autosomal recessive diseases resulting from defects in steps of the synthesis of cortisol from cholesterol by the adrenal glands. ... Congenital adrenal hyperplasia due to 21-hydroxylase deficiency, in all its forms, accounts for about 95% of diagnosed cases of congenital adrenal hyperplasia, and CAH in most contexts refers to 21-hydroxylase deficiency. ... Conns syndrome is overproduction of the mineralocorticoid hormone aldosterone by the adrenal glands. ... Bartter syndrome is a rare genetic disease characterized by low potassium levels (hypokalemia), decreased acidity of blood (alkalosis), and normal to low blood pressure. ... In medicine, adrenal insufficiency (or hypocortisolism) is the inability of the adrenal gland to produce adequate amounts of cortisol in response to stress. ... Addisons disease(also known as chronic adrenal insufficiency, hypocortisolism or hypocorticism) is a rare endocrine disorder in which the adrenal gland produces insufficient amounts of steroid hormones (glucocorticoids and often mineralocorticoids). ... In medicine (endocrinology), hypoaldosteronism refers to decreased levels of the hormone aldosterone. ... The gonad is the organ that makes gametes. ... Polycystic ovary syndrome (PCOS, also known clinically as Stein-Leventhal syndrome), is an endocrine disorder that affects approximately one in ten women. ... Premature Ovarian Failure (POF) is the cessation of menstrual periods and ovulation in women under the age of 40. ... It has been suggested that this article or section be merged with Guevedoche. ... 17-beta-hydroxysteroid dehydrogenase deficiency is a rare disorder of sexual development which can produce impaired virilization (traditionally termed male pseudohermaphroditism) of genetically male infants and children and excessive virilization of female adults. ... Hypogonadism is a medical term for a defect of the reproductive system which results in lack of function of the gonads (ovaries or testes). ... Puberty is described as delayed when a boy or girl has passed the usual age of onset of puberty with no physical or hormonal signs that it is beginning. ... Precocious puberty means early puberty. ... Androgen insensitivity syndrome (AIS, or Androgen resistance syndrome) is a set of disorders of sexual differentiation that results from mutations of the gene encoding the androgen receptor. ... In medicine, autoimmune polyendocrine syndromes are a heterogenous group of rare diseases characterised by autoimmune activity against more than one endocrine organs, although non-endocrine organs can be affected. ... Carcinoid syndrome refers to the array of symptoms that occur secondary to carcinoid tumors. ... Anna Haining Bates with her parents Greek gigas, gigantus (giant) is a condition characterized by excessive height growth and bigness. ... People who are shorter have short stature. ... Laron syndrome is a disorder characterized by an insensitivity to growth hormone, caused by a variant of the growth hormone receptor. ... Psychogenic dwarfism, Psychosocial dwarfism or Stress dwarfism is a growth disorder that is observed between the ages of 2 and 15, caused by extreme emotional deprivation or stress. ... Multiple endocrine neoplasia (MEN) (or multiple endocrine adenomas, or multiple endocrine adenomatosis -- MEA) consists of three syndromes featuring tumors of endocrine glands, each with its own characteristic pattern. ... Multiple endocrine neoplasia type 1 is part of a group of disorders that affect the endocrine system. ... Multiple endocrine neoplasia type 2 is part of a group of disorders that affect the endocrine system. ... The term Progeria narrowly refers to Hutchinson-Gilford Progeria syndrome, but the term is also used more generally to describe any of the so-called accelerated aging diseases. The word progeria is derived from the Greek for prematurely old. Because the accelerated aging diseases display different aspects of aging, but...

  Results from FactBites:
 
Graves' Disease (999 words)
Graves' Disease is a type of autoimmune disease that causes over-activity of the thyroid gland, causing hyperthyroidism.
Graves’ Disease also tends to affect women between the ages of 20 and 40, although it occurs in infants, children, and the elderly.
Graves’ Disease is the only kind of hyperthyroidism that is associated with swelling of the tissue around the eyes and bulging of the eyes.
Graves Disease (1710 words)
Graves' disease is a term used to describe the commonest variety of hyperthyroidism, which is regarded as having an autoimmune basis.
Autoimmune disease may be understood as a process by which the body sees some part of itself as being foreign and reacts to it much the same way that it would with any bacteria or virus.
For Graves’ disease, medication is usually prescribed for 18 months with frequent follow-up treatments involving blood tests (every two to three months) and the appropriate adjustment of dosage.
  More results at FactBites »

 
 

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