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Grave's Disease: Symptoms, Causes, Diagnosis & Treatment
Also known as toxic diffuse goitre, Grave's disease is an autoimmune disease that affects the thyroid. It causes the over production of thyroid hormones, making it the major cause of hyperthyroidism. Basically, the condition is developed as a result of an over-active thyroid gland that can have serious consequences, if left untreated [1] .
One of the most common autoimmune condition, Grave's disease is commonly found in women and before the age of 40. However, it has also been reported in men. The condition was initially named as 'exophthalmic goitre', but has been renamed after Sir Robert Graves, an Irish doctor who first described the condition in 1835 [2] .
Grave's disease can affect your overall well-being and is easy to treat. The primary approach towards the condition is treating the symptoms and controlling the over-production of thyroid hormones [3] .
Symptoms Of Grave's Disease
Some of the most common signs of the autoimmune condition are as follows [4] :
- Anxiety
- Irritability
- Hand and finger tremors
- Heat sensitivity
- Change in menstrual cycles
- Increased sweating
- Sensitivity to heat
- Weight loss
- Enlargement of your thyroid gland (goitre)
- Erectile dysfunction
- Reduced libido
- High blood pressure
- Thick, red skin usually on the shins or tops of the feet (Graves' dermopathy)
- Frequent bowel movements
- Bulging eyes (Graves' ophthalmology)
- Fatigue
- Vision problems
- Rapid or irregular heartbeat (palpitations)
Causes Of Grave's Disease
The condition is caused when the body's disease-fighting immune system malfunctions. Apart from this, the exact cause of Grave's condition is not known. When your body develops the condition, it is asserted that the body produces an antibody to one part of the cells in the thyroid gland, but the reason behind this is still not clearly understood to researchers and health practitioners [5] .
Some studies reveal that Grave's disease could be caused by a combination of genetic and environmental factors. That is, a family history of the autoimmune disease increases your risk of developing the condition, although its inheritance pattern is unknown. The habit of smoking is also linked as a cause[6] .
Risk Factors For Grave's Disease
Though studies point out that anyone can develop the condition, there are some factors that can increase the risk and they are as follows[7] :
- Age
- Family history
- Gender
- Emotional or physical stress
- Other autoimmune disorders
- Pregnancy
- Smoking
Complications Of Grave's Disease
The autoimmune condition can impact your overall health. The major complications pertaining to Grave's disease are as follows [8] :
- Pregnancy issues such as miscarriage, pre-term birth, foetal thyroid dysfunction, poor foetal growth, maternal heart failure and preeclampsia.
- Thyroid storm (also known as accelerated hyperthyroidism or thyrotoxic crisis).
- Heart disorders.
- Brittle bones (osteoporosis).
Diagnosis Of Grave's Disease
The doctor will carry out a physical examination in which he/she will examine your eyes to check whether they're irritated or protruding. Your thyroid gland will also be examined, along with your pulse and blood pressure[9] .
Apart from that, the doctor will run a blood test so as to determine your levels of thyroid-stimulating hormone.
You may be given a small amount of radioactive iodine, which will be measured late with a specialized scanning camera which will help the doctor determine the rate at which your thyroid gland takes up iodine[10] .
An ultrasound will be conducted which will help understand if the thyroid gland is enlarged. The imaging tests such as a CT scan or and MRI may also be carried out.
Treatment For Grave's Disease
The methods aim to manage the symptoms and inhibit the production of thyroid hormones, as well as to block the effect of the hormones on the body[11] .
The treatments for Grave's disease are as follows:
- Radioactive iodine therapy
- Anti-thyroid medications
- Beta blockers
- Surgery
- [1] Smith, T. J., & Hegedüs, L. (2016). Graves’ disease. New England Journal of Medicine, 375(16), 1552-1565.
- [2] Kummer, S., Hermsen, D., & Distelmaier, F. (2016). Biotin treatment mimicking Graves’ disease. New England Journal of Medicine, 375(7), 704-706.
- [3] Burch, H. B., & Cooper, D. S. (2015). Management of Graves disease: a review. Jama, 314(23), 2544-2554.
- [4] van der Kaay, D. C., Wasserman, J. D., & Palmert, M. R. (2016). Management of neonates born to mothers with Graves’ disease. Pediatrics, 137(4), e20151878.
- [5] Bartalena, L., Burch, H. B., Burman, K. D., & Kahaly, G. J. (2016). A 2013 European survey of clinical practice patterns in the management of Graves' disease. Clinical endocrinology, 84(1), 115-120.
- [6] Wu, S. Y., Leung, A. M., Chambers, M. D., Chen, C. L., Khan, M. U., Brent, G. A., & Green, W. L. (2018). Coexistent presentation of Graves' disease and an autonomous thyroid nodule following administration of an iodinated contrast load. Journal of Clinical and Translational Endocrinology: Case Reports, 9, 1-3.
- [7] Barbesino, G. (2016). Misdiagnosis of Graves' disease with apparent severe hyperthyroidism in a patient taking biotin megadoses. Thyroid, 26(6), 860-863.
- [8] Elston, M. S., Sehgal, S., Du Toit, S., Yarndley, T., & Conaglen, J. V. (2016). Factitious Graves’ disease due to biotin immunoassay interference—a case and review of the literature. The Journal of Clinical Endocrinology & Metabolism, 101(9), 3251-3255.
- [9] Léger, J. (2017). Management of fetal and neonatal Graves' disease. Hormone research in paediatrics, 87(1), 1-6.
- [10] Marinò, M., Latrofa, F., Menconi, F., Chiovato, L., & Vitti, P. (2015). Role of genetic and non-genetic factors in the etiology of Graves’ disease. Journal of endocrinological investigation, 38(3), 283-294.
- [11] Ma, C., Xie, J., Wang, H., Li, J., & Chen, S. (2016). Radioiodine therapy versus antithyroid medications for Graves' disease. Cochrane Database of Systematic Reviews, (2).
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