Case study - Grave's Disease
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Carley, a 32-year-old woman, presented with symptoms of excess sweating, fast heartbeat, and diarrhea. She also had puffy eyes, high blood pressure, and an enlarged thyroid. Tests showed elevated thyroid hormones and radioactive iodine uptake by the thyroid. The diagnosis was determined to be Graves' disease, an autoimmune disorder caused by antibodies that stimulate the thyroid-stimulating hormone receptor, causing overproduction of thyroid hormones and an enlarged thyroid. Treatments include radioactive iodine therapy, anti-thyroid medications, and beta blockers.
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Diffuse toxic goiter, also known as endemic goiter, is an autoimmune disease characterized by overproduction of thyroid hormones causing damage to organs like the nervous and cardiovascular systems. It is caused by iodine deficiency in the environment, especially in soil and water. People in iodine-deficient areas can develop an enlarged thyroid gland with a reduction in its function over time, along with symptoms like difficulty swallowing and changes to heart function. Treatment options include thyroid drugs, surgery to remove part of the thyroid gland, and preventing future cases by providing iodized salt and foods to populations.
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Graves' disease is an autoimmune disorder that causes hyperthyroidism or overactivity of the thyroid gland. It is most common in women over age 20. Symptoms include anxiety, rapid heartbeat, eye problems, fatigue, and weight loss. Graves' disease occurs when the immune system produces antibodies that mimic the effects of thyroid stimulating hormone, causing the thyroid gland to overproduce thyroid hormones. Treatments include antithyroid medications, radioactive iodine, or surgery to destroy the thyroid gland, followed by lifelong thyroid hormone replacement. While treatments are usually effective, there is a risk of developing hypothyroidism if the replacement hormone dose is incorrect.
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Graves' disease, also known as toxic diffuse goiter, is the most common cause of hyperthyroidism in the United States.
Hyperthyroidism is a disorder that occurs when the thyroid gland makes more thyroid hormone than the body needs.
Hashimoto’s thyroiditis
Hashimoto's thyroiditis is an autoimmune condition that is a common cause of hypothyroidism.
In Hashimoto's thyroiditis, the body mounts an immune reaction against its own thyroid gland tissue, leading to inflammation of the gland (thyroiditis).
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Thyrotoxicosis, or hyperthyroidism, is caused by excessive thyroid hormones. It can be primary, resulting from conditions like Graves' disease, or secondary, from a toxic multinodular goiter or toxic adenoma. Graves' disease is an autoimmune disorder caused by antibodies that stimulate the thyroid. Symptoms include hypermetabolism, nervousness, and eye changes. Diagnosis involves thyroid function tests, ultrasound, and radioactive iodine uptake. Treatment options are antithyroid medications, radioactive iodine therapy, or surgery. Complications can include thyroid storm, which is a medical emergency requiring aggressive treatment.
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Most common thyroid disorders are hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Hyperthyroidism symptoms include nervousness, palpitations, sweating, and eye changes. Causes include Graves' disease and ingestion of excess thyroid hormone. Treatment involves anti-thyroid medications, radioactive iodine, or surgery. Hypothyroidism causes fatigue, weight gain, dry skin and is most often due to autoimmune disease or previous thyroid surgery/radiation. Levothyroxine replacement is the standard treatment monitored through thyroid hormone level testing.
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- Graves' disease is the most common cause of hyperthyroidism in pediatric patients, accounting for 10-15% of thyroid disorders in those under 18.
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Thyrotoxicosis
This document discusses hyperthyroidism (excess thyroid hormone). There are two main types - those caused by excess hormone production and those caused by release of stored hormone. Primary causes include Graves' disease while secondary causes include Plummer's disease and toxic nodules. Signs and symptoms, investigations, and treatment options like antithyroid drugs, surgery, and radioiodine are described for different patient groups. Management involves controlling hyperthyroidism and returning the patient to a euthyroid state.
Thyrotoxicosis
Thyrotoxicosis, or hyperthyroidism, is caused by excessive thyroid hormones. It can be primary, resulting from conditions like Graves' disease, or secondary, from a toxic multinodular goiter or toxic adenoma. Graves' disease is an autoimmune disorder caused by antibodies that stimulate the thyroid. Symptoms include hypermetabolism, nervousness, and eye changes. Diagnosis involves thyroid function tests, ultrasound, and radioactive iodine uptake. Treatment options are antithyroid medications, radioactive iodine therapy, or surgery. Complications can include thyroid storm, which is a medical emergency requiring aggressive treatment.
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- Thyrotoxicosis is defined as thyroid hormone excess and can be caused by hyperthyroidism, thyroiditis, or excess hormone ingestion. The major causes of hyperthyroidism are Graves' disease, toxic multinodular goiter, and toxic adenomas.
- Clinical manifestations depend on severity and duration of thyrotoxicosis, and include symptoms like palpitations, sweating, weight loss as well as signs like goiter, tremor, eye changes. Diagnosis involves testing thyroid function through TSH,
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- The anatomy and blood supply of the thyroid gland.
- Thyroid follicles which are the functional units that secrete thyroid hormones like T4 and T3.
- The two main thyroid disorders - hypothyroidism which is an underactive thyroid, and hyperthyroidism which is an overactive thyroid.
- The most common causes of hypothyroidism including Hashimoto's thyroiditis, and the signs, symptoms, and treatment which involves thyroid hormone replacement.
- Graves' disease as the most common cause of hyperthyroidism, along with its autoimmune pathogenesis and associated signs and
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Hyperthyroidism is a hypermetabolic state caused by increased thyroid secretion. There are several types, including Graves' disease (the most common cause), toxic nodular goitre, and toxic adenoma. Clinical features include symptoms like fatigue, heat intolerance, and weight loss, as well as signs like tachycardia, eye changes, and thyroid swelling. Diagnosis involves clinical evaluation, thyroid function tests, and scans. Treatment options are antithyroid drugs, surgery, and radioactive iodine.
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This document discusses hyperthyroidism and its treatment. It defines hyperthyroidism as increased secretion of thyroid hormones due to various stimuli. It then describes the clinical types of hyperthyroidism including diffuse toxic goitre (Graves' disease), toxic nodular goitre, and toxic nodule. The document outlines the symptoms, diagnosis, and principles of treatment for hyperthyroidism including anti-thyroid drugs, radioactive iodine therapy, and surgery. Treatment options depend on factors like the type and severity of hyperthyroidism, patient age and preferences.
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- It results from antibodies that bind to receptors on the thyroid, causing enlarged thyroid and excessive hormone production. Symptoms include goiter, tachycardia, weight loss, and occasionally eye involvement.
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Graves disease is an autoimmune disorder where the thyroid gland becomes overactive. It causes the thyroid to enlarge and produce too much thyroid hormone. Symptoms include bulging eyes from muscles swelling behind the eyes, and an enlarged thyroid visible as a bulge on the neck. Treatment options include medication to slow the thyroid or surgical removal of the thyroid gland, leaving a scar on the neck.
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Grave's disease is an autoimmune disease where the immune system attacks the thyroid gland, causing it to produce more thyroid hormones and leading to symptoms like anxiety, rapid heartbeat, and bulging eyes. It affects mostly women and is diagnosed through physical exams, blood tests, and radioactive iodine tests. Treatments include beta blockers, anti-thyroid medications, and radioactive iodine to destroy part of the thyroid gland. Family history, sex, age, stress, pregnancy, and smoking can increase the risk of developing Grave's disease.
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- 1. Case Study - Grave’s Disease By: Michael Petrich
- 2. Background Carley, a 32 year old woman, has come in for her anxiety. Carley says that she is experiencing: excess sweating, can feel her heart beat faster than usual, and is also having diarrhea. It should be noted that Sarah appears to have puffy eyes, high blood pressure, and enlarged thyroid.
- 3. What is Your Initial Diagnosis of Sarah?
- 4. What Tests Would You Run to Confirm a Diagnosis?
- 5. Tests • Blood sample • Tests levels of thyroid stimulating hormone • Tests levels of thyroid hormones • Radioactive iodine uptake • Measures the rate at which the thyroid takes up iodine • Ultrasound • High frequency sounds waves to produce an image
- 6. What Diagnosis Would You Give?
- 7. Grave’s Disease Carley has Grave’s disease. This is most common is women under 40 and is usually genetic but can come from smoking. Grave’s disease is caused by autoantibodies to the the thyroid stimulating hormone receptors on follicular cells and mimicking the receptor activation actions of the original thyroid stimulating hormone. The resulting consequence is stimulation follicular cell growth (thyroid enlargement) and increased production of thyroid hormones.
- 9. Symptoms
- 10. Thyroid Stimulating Hormone Receptor • The TSHR is a G-protein coupled receptor with seven transmembrane- spanning domains • TSH, acting via the TSHR, regulates thyroid growth and thyroid hormone production and secretion. The TSHR undergoes complex post-translational processing involving dimerization and intramolecular cleavage • The latter modification leaves a two-subunit structural form of the receptor. • Each of these post-translational events may influence the antigenicity of the receptor
- 11. Disease State • The majority of intrathyroidal lymphocytes are T cells but plenty of B cells may be present in Grave’s disease • In some areas, thyroid epithelial cell size correlates with the intensity of the lymphocytic infiltrate, suggesting thyroid-cell stimulation by local B cells secreting stimulating thyroid antibodies • Graves disease carrier protein is a protein of as yet uncharacterised function that belongs to the mitochondrial metabolite carrier family (which includes the ADP/ATP translocator, the phosphate carrier and the hydrogen ion uncoupling protein) • The protein is recognized by IgG from patients with active Graves disease • The predicted amino acid sequence is 348 residues
- 12. Treatments • Radioactive Iodine Therapy • Thyroid needs iodine to produce hormones, radioactivity breaks down overactive thyroid hormone cells overtime. • Anti-Thyroid Medications • Interferes with the thyroid’s use of iodine to produce hormones • Beta Blockers • Don’t inhibit the production of hormones, but do block the effect of hormones in the body