Everything you wanted to know about Graves' disease.

摘要: Graves' disease is an autoimmune thyroid characterized by a genetic predisposition, increased incidence in young women, the presence of thyroid-stimulating immunoglobulins, and uncertain etiology. The onset occasionally follows frightening episode patient's life or separation from loved one. On physical examination, patient has diffuse goiter with secondary hyperthyroidism, noninfiltrative/infiltrative ophthalmopathy, and, on occasion, infiltrative dermopathy. Atypical symptoms, signs, presentations such as "apathetic thyrotoxicosis" are not rare may delay diagnosis some patients. confirmed elevations bound thyroxine (T 4 ), free T , triiodothyronine hormone levels less than 0.1 mU/L. When suspected, but unclear, thyrotropin-releasing stimulation test indicated. Medical therapy must be long-term when propylthiouracil methimazole used, results only 25% to 50% remissions at 1 2 years. Radioactive iodine resulted need for retreatment 33.7% patients past, hypothyroidism occurs 70% 100% treated 10 years, depending dose. Evolving changes operative technique have led 95% cure rate complications reoperation hemorrhage (0% 1.3%), recurrent nerve palsy 4.5%), permanent hypocalcemia 0.6%) extraordinarily low experienced hands. Greater 90% remained euthyroid years after thyroidectomy several series. Surgery continues ofter highest shortest period time.