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Encyclopedia > Graves disease
Graves disease
Classification & external resources
ICD-10 E05.0
ICD-9 242.0
OMIM 275000
MedlinePlus 000358
eMedicine med/929  ped/899
MeSH D006111

Graves disease is a thyroid disorder characterized by goiter, exophthalmos, "orange-peel" skin, 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. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // E00-E35 - Endocrine diseases (E00-E07) Disorders of thyroid gland (E00) Congenital iodine-deficiency syndrome (E01) Iodine-deficiency-related thyroid disorders and allied conditions (E02) Subclinical iodine-deficiency hypothyroidism (E03) Other hypothyroidism (E030) Congenital hypothyroidism with diffuse goitre (E031) Congenital hypothyroidism without goitre (E032) Hypothyroidism due to medicaments and other... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Mendelian Inheritance in Man project is a database that catalogues all the known diseases with a genetic component, and - when possible - links them to the relevant genes in the human genome. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... 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. ...


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 Randy Danny 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. ... Portrait of Edward Jenner Edward Jenner, FRS, (17 May 1749 – 26 January 1823) was an English country doctor who studied nature and his natural surroundings from childhood and practiced medicine 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. ... Motto Esteqlāl, āzādÄ«, jomhÅ«rÄ«-ye eslāmÄ« 1(Persian) Independence, freedom, Islamic Republic (introduced 1979) Anthem SorÅ«d-e MellÄ«-e Īrān 2 Capital (and largest city) Tehran Official languages Persian Demonym Iranian Government Islamic Republic  -  Supreme Leader  -  President Establishment  -  Proto-Elamite Period 3200-2700 BCE... 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:

  • goiter (an enlarged thyroid gland, sometimes detectable as a swelling in the neck)
  • exophthalmos (protuberance of one or both eyes)
  • a non-pitting edema 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 nonpitting edema. Goiter, which is caused by an enlarged thyroid gland, 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. 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. ... 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... Ultrasound is a form of cyclic sound pressure with a frequency greater than the upper limit of human hearing, this limit being approximately 20 kilohertz (20,000 hertz). ...


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 causating factor in some patients. Hyperthyroidism can be confirmed by measuring elevated blood levels 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. ... General Name, Symbol, Number iodine, I, 53 Chemical series halogens Group, Period, Block 17, 5, p Appearance violet-dark gray, lustrous Standard atomic weight 126. ... Serology is the scientific study of blood serum. ...


Definitive diagnosis requires a biopsy. 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. ...


Other Graves' Disease Symptoms

Some of the most typical symptoms of Graves' Disease are 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 eg. 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 (Graves' disease only)
  • Double vision
  • Eye pain, irritation, 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

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. Tissue behind the eye can become swollen or fibrous, causing the characteristic symptom of bulging eyes. 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 Inmunoglobulins: 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.[7] 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.[7] 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.[8] 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.[9] More recently the role for Y. enterocolitica has been disputed.[10] 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 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

Medical treatment of Graves' disease includes antithyroid drugs, radioactive iodine and thyroidectomy (surgical excision of the gland). General Name, Symbol, Number iodine, I, 53 Chemical series halogens Group, Period, Block 17, 5, p Appearance violet-dark gray, lustrous Standard atomic weight 126. ... A thyroidectomy involves the surgical removal all or part of the thyroid gland. ...


Treatment of the hyperthyroidism of Graves disease may be with medications such as carbimazole, methimazole or propylthiouracil (PTU), which reduce the production of thyroid hormone, or with radioactive iodine. Surgical removal of the thyroid is another option, but still requires preoperative treatment with methimazole or PTU. This is done to render the patient "euthyroid" (i.e. normothyroid) before the surgery since operating on a frankly hyperthyroid patient is dangerous. Therapy with radioactive iodine (I-131) is the most common treatment in the United States. Thyroid blocking drugs and/or surgical thyroid removal is used more often than radioactive iodine as definitive treatment in Europe, Japan, and most of the rest of the world. Propylthiouracil is a thioamide drug used to treat hyperthyroidism. ... 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. ...


The development of radioactive iodine (I-131) in the early 1940s at the Mallinckrodt General Clinical Research Center and its widespread adoption as treatment for Graves' Disease 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. 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 Mallinckrodt MGH General Clinical Research Center (GCRC) is a research center at Massachusetts General Hospital. ...


Antithyroid drugs

The main antithyroid drugs are methimazole (US), carbimazole (UK) and propylthiouracil. 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. Methimazole is an antithyroid drug similar in action to propylthiouracil. ... Carbimazole is used to treat hyperthyroidism. ... 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 is an ephemeral (temporary) organ present in female placental vertebrates during gestation (pregnancy), but a placenta has evolved independently also in other animals as well, for instance scorpions and velvet worms. ...


Radioiodine

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. 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. A pregnant woman near the end of her term Pregnancy is the carrying of one or more offspring in an embryonal or fetal stage of development by female mammals, including humans, inside their bodies, between the stages of conception and birth. ... 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. The trachea, or windpipe, is a tube that has an inner diameter of about 12mm and a length of about 10-16cm. ... 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 an elbow, nine days after a blood sample was taken Hematoma on a forearm, one day after repeated shocks 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. ...


Herbal

For treating Graves disease, along with many other thyroid disorders, one can use the herb bugleweed.[citation needed] This herb has a profound effect on thyroid function and regulation of thyroid hormones. The name bugleweed can refer to two unrelated plants: Bugle (plant), taxonomically Ajuga Lycopus, the genus to which the gypsywort belongs Category: ...


Eye disease

Thyroid-associated ophthalmopathy is one of the most typical symptom of Graves Disease. It is known by a variety of terms, the commonest 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. Graves ophthalmopathy, also known by any of the combinations of Graves~/thyroid~/thyroid-associated~/dysthyroid~ with ~ophthalmopathy/~orbitopathy/~exophthalmos, is an autoimmune inflammatory disorder affecting the orbit, with or without thyroid disorder. ...


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.

  • 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. ... Tarsorrhaphy is a surgical procedure in which the eyelids are partially sewn together to narrow the opening. ...

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. 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 accidental termination of a pregnancy at a stage where the embryo or the fetus is incapable of surviving, generally defined at a gestation of prior to 20 weeks. ...


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, formerly of the Chicago Bears, Penn State Nittany Lions, and Camden High School Bulldogs (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.
  • John F. Kennedy Jr. was diagnosed with Graves' disease several years before his death in 1999.
  • Marty Feldman, English writer, comedian and film and television actor. The illness affected the appearance of his eyes which bulged.
  • 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.

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 an abnormal heart rhythm (cardiac arrhythmia) which involves the two small, upper heart chambers (the atria). ... 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. ... The House of Commons (French: Chambre des communes) is a component of the Parliament of Canada, along with the Sovereign (represented by the Governor General) and the Senate. ... Nadezhda Krupskaya Nadezhda K. Krupskaya ( February 26, 1869 - February 27, 1939) was a Russian Marxist revolutionary. ... Vladimir Ilyich Lenin (Vladimir Ilyich Ulyanov) Russian: , IPA: , better known by the alias   () (April 22, 1870 – January 21, 1924), was a Russian revolutionary, a communist politician, the main leader of the October Revolution, the first head of the Russian Soviet Socialist Republic and from 1922, the first de facto leader... Bolshevik Party Meeting. ... 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... City Chicago, Illinois Other nicknames Da Bears, The Monsters of the Midway Team colors Navy Blue, Orange and White Head Coach Lovie Smith Owner Virginia Halas McCaskey Chairman Michael McCaskey General manager Jerry Angelo Fight song Bear Down, Chicago Bears Mascot Staley Da Bear League/Conference affiliations Independent (1919) National... The Penn State Nittany Lions (men) and Lady Lions are the athletic teams of Pennsylvania State University. ... 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. ... John F. Kennedy Jr. ... Martin Alan Marty Feldman (July 8, 1934 – December 2, 1982) was an English writer, comedian and film and television actor, famous 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. ... John Adams, Jr. ...

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. ^ a b Tomer Y, Davies T (1993). "Infection, thyroid disease, and autoimmunity." (PDF). Endocr Rev 14 (1): 107-20. PMID 8491150. 
  8. ^ Toivanen P, Toivanen A (1994). "Does Yersinia induce autoimmunity?". Int Arch Allergy Immunol 104 (2): 107-11. PMID 8199453. 
  9. ^ 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. 
  10. ^ 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. 

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

  • Graves ophthalmopathy

Graves ophthalmopathy, also known by any of the combinations of Graves~/thyroid~/thyroid-associated~/dysthyroid~ with ~ophthalmopathy/~orbitopathy/~exophthalmos, is an autoimmune inflammatory disorder affecting the orbit, with or without thyroid disorder. ...

External links

  • 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.



  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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