This PPT covers the concepts of Pathophysiology of Graves disease. It include pathophysiology, symptoms, diagnosis and treatment

1. PREPARED BY: JEGAN. S. NADAR
GRAVES DISEASE

2. GRAVES DISEASE
 Graves' disease, also known as toxic diffuse goiter, is an autoimmune
disease that affects the thyroid
 Graves’ disease is a type of autoimmune problem that causes the thyroid
gland to produce too much thyroid hormone
 It is the most common cause of hyperthyroidism
 It also often results in an enlarged thyroid
Jegan

3.  Graves' disease will develop in about 0.5% of males and 3% of females.
 It occurs about 7.5 times more often in women than men
 The exact cause is unclear; however, it is believed to involve a combination
of genetic and environmental factors
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4.  Genetics
 A genetic predisposition for Graves' disease is seen, with some people
more prone to develop TSH receptor activating antibodies due to a
genetic cause
 Infectious trigger
 Graves' disease is an autoimmune disease which appears suddenly, often
later in life, a viral or bacterial infection may trigger antibodies which
cross-react with the human TSH receptor, a phenomenon known as antigenic
mimicry
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5.  It is an autoimmune disease
 There is trigger in production of antibodies
 These antibodies has structural similarities to the thyroid stimulating hormone (TSH)
 These antibody will bind to the thyroid stimulating hormone receptor (TSHR)
instead of TSH
 Binding of these antibody leads to activation of this receptor
 Once this receptor is activated there is excess production of the hormone T3 and T4
 This, in turn, causes the clinical symptoms of hyperthyroidism, and the enlargement of
the thyroid gland visible as goiter
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6. Jegan

7. AUTOANTIBODIES TO THE TSH RECEPTOR
 The three types of autoantibodies to the TSH receptor currently recognized
are:
 Thyroid stimulating immunoglobulins
 Thyroid growth immunoglobulins
 Thyrotrophin binding-inhibiting immunoglobulins
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8. SYMPTOMS
 Exophthalmos
 Goiter
 Insomnia
 Hand tremor
 Hair loss, excessive sweating
 Itching, heat intolerance,
 Weight loss despite increased appetite
 Diarrhea, frequent defecation
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9. GOITER
EXOPHTHALMOS

10. DIAGNOSIS
 Physical exam
 Blood test (TSH level)
 Iodine uptake test
 MRI
 CT scan

11. TREATMENT
 Radioactive iodine therapy
 Anti-thyroid medications- Propylthiouracil and Methimazole
 Beta blockers
 Surgery
Jegan

12. Thank You
Jegan