Graves' disease:Generalized diffuse overactivity ("toxicity") of the entirethyroid glandwhich becomes enlarged into agoiter. Graves'diseaseis the most common cause of hyperthyroidism.
There are three components to Graves' disease:
- Hyperthyroidism(the presence of too muchthyroid hormone),
- Ophthalmopathyspecifically involvingexophthalmos(突出the eyeballs),
- Dermopathywithskinlesions.
The ophthalmopathy can causesensitivityto light and a feeling of "sandinthe eyes." With further protrusion of the eyes, double vision and vision loss may occur. The ophthalmopathy tends to worsen with smoking. The dermopathy of Graves' disease is a rare, painless, reddish lumpy skin rash that of Graves' disease is anautoimmune process. It is caused bythyroid-stimulating antibodies which bind to and activate thethyrotropinreceptoron thyroid cells.
Graves' disease can run in families. The rate ofconcordancefor Graves' disease is about 20% among monozygotic (identical) twins, and the rate is much lower among dizygotic (nonidentical) twins, indicating thatgenesmake only a moderate contribution to the susceptibility to Graves' disease. No singlegeneis known to cause the disease or to be necessary for itsdevelopment. There are well-established associations with certainHLAtypes.Linkage analysishas identified gene loci onchromosomes14q31, 20q11.2, and Xq21 that are associated with susceptibility to Graves' disease.
Factors that cantriggertheonsetof Graves' disease include stress,smoking, radiation to theneck, medications (such as白介素2andinterferon-alpha), and infectious organisms such asviruses.
Thediagnosisof Graves' disease is made by a characteristic thyroid scan (showing diffusely increase uptake), the characteristic triad of ophthalmopathy, dermopathy, and hyperthyroidism, orbloodtesting forTSI(thyroid stimulating immunoglobulin) the level of which is abnormally high.
Current treatments for the hyperthyroidism of Graves' disease consist of antithyroid drugs,放射性iodine, andsurgery. There is regional variation in which of these measures tends to be used -- for example,放射性iodineis favored in North America and antithyroid drugs nearly everywhere else. The surgery, subtotalthyroidectomy, is designed to remove the majority of the overactive thyroidgland.
The disease is named for Robert Graves' who in 1835 first identified theassociationof goiter, palpitations, and exophthalmos. Graves' disease is also commonly known asdiffuse toxic goiter.
Other spellings include Grave's disease and Graves disease.
