Hyperthyriodism and graves disease


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Hyperthyriodism and graves disease

  1. 1. HYPERTHYROIDISM By, Pranav Khawale, BNYS(2nd Year)
  2. 2. CONTENTS• Definition• Etiopathogenesis• Clinical features• Risk Factors• Signs and Symptoms• Differential Diagnosis• Diagnosis
  3. 3. DEFINITION• Hyperthyroidism occurs when the thyroid gland produces excessive amounts of thyroid hormone
  4. 4. ETIOPATHOGENESIS• Hyperthyroidism may be caused by many diseases but three most common causes are: 1. Grave’s disease 2. Toxic multinodular goitre 3. Toxic adenoma• Hypersecretion of pituitary TSH by a pituitary tumor• THR hypersecrection• Thyroiditis• Metastatic tumor of thyroid
  5. 5. CLINICAL FEATURES• Emotional instability• Nervousness• Palpitation• Fatigue• Weight loss• Perspiration• Menstrual disturbances• Skin is warm• Weakness of skeletal muscles• Osteoporosis is common
  6. 6. RISK FACTORS• Age between 20 and 40 years• Stress• Pregnancy• In newborns, a mother with Graves disease• Intestinal dysbiosis• Antibiotic overusage• Family history
  7. 7. SIGNS AND SYMPTOMS• Tachycardia• Tachyarhythmia/palpitations• Bruit over thyroid gland• Hypertension• Swelling at the base of the neck• Moist skin and increased perspiration• Shakiness and tremor• Nervousness
  8. 8. • Confusion• Increased appetite accompanied by weight loss• Difficulty in sleeping• Swollen, reddened, and bulging eyes• Constant stare (infrequent blinking, lid lag)• Sensitivity of eyes to light• In thyroid storm: fever, very rapid pulse, agitation, and possibly delirium• Altered menses
  9. 9. DIFFERENTIAL DIAGNOSIS• Depression• Anxiety• Hyperactivity• Neurologic disease with resultant tremor• Heart disease• Drugs
  10. 10. DIAGNOSIS• Physical Examination• Laboratory Tests o Serum thyroxine (T4) assay o Serum triiodothyronine (T3) assay
  11. 11. • Other Diagnostic Procedures o Perform a radioactive iodine uptake test o Radioactive iodine uptake tests indicate the source of the overstimulation that results in the disease o Thyroid ultrasound
  12. 12. GRAVES’ DISEASEGraves’ disease also known as Basedow’s disease
  13. 13. GRAVES’ DISEASE• Most common cause of thyrotoxicosis• TSH-R antibody (stim)• Goitre, Orbitopathy, Dermopathy• This disease is more frequently between the age of 30 and 40 years• and has increased prevalence in females
  14. 14. ETIOPATHOGENESIS• Graves’ disease is an autoimmune disease• HLA association- graves’ disease has genetic predisposition• Autoimmune disease association-graves’ disease may be found in association with other organ-specific autoimmune diseases• Other factor-emotional stress and smoking
  15. 15. • In patients with Grave’s disease, eye signs may precede, coincide with or follow the hyperthyroidism• Sometimes similar eye signs are seen without a detectable thyroid abnormality
  16. 16. PathologyActivated T cells infiltrate orbital contentsand stimulate fibroblasts, leading to:1. Enlargement of extraocular muscles2. Cellular infiltration of interstitial tissues3. Proliferation of orbital fat and connective tissue
  17. 17. PATHOLOGICAL CHANGES• Grossly- • The thyroid is moderately, diffusely and symmetrically enlarged • Weight upto 70-90 gm•Histologically- •Considerable epithelial hyperplasia and hypertrophy •The colloid is markedly diminished and is lightly staning
  18. 18. CLINICAL FEARTURES• Slowly and insidiously• Ophthalmopathy and dermatopathy• Ocular abnormalities
  19. 19. REFERENCES• Bartram T. Encyclopedia of Herbal Medicine. Dorset, England: Grace Publishers; 1995:422• Text book of pathology • (Harsh Mohan), 5th edition
  20. 20. THANK YOU…