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Hyperthyriodism and graves disease
Hyperthyroidism, also known as Graves' disease, occurs when the thyroid gland produces excessive amounts of thyroid hormone. The most common causes are Graves' disease, toxic multinodular goiter, and toxic adenoma. Clinical features include emotional instability, palpitations, weight loss, and warm skin. Diagnosis involves physical examination, thyroid hormone blood tests, and imaging tests such as thyroid ultrasound. Graves' disease is the most common cause of hyperthyroidism and is an autoimmune disease associated with eye and skin changes.
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Hyperthyriodism and graves disease
- 1. HYPERTHYROIDISM By, Pranav Khawale, BNYS(2nd Year)
- 2. CONTENTS • Definition • Etiopathogenesis • Clinical features • Risk Factors • Signs and Symptoms • Differential Diagnosis • Diagnosis
- 3. DEFINITION • Hyperthyroidism occurswhen the thyroid gland produces excessive amounts of thyroid hormone
- 4. ETIOPATHOGENESIS • Hyperthyroidism maybe 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. CLINICAL FEATURES • Emotional instability • Nervousness • Palpitation • Fatigue • Weight loss • Perspiration • Menstrual disturbances • Skin is warm • Weakness of skeletal muscles • Osteoporosis is common
- 6. RISK FACTORS • Age between 20 and 40 years • Stress • Pregnancy • In newborns, a mother with Graves' disease • Intestinal dysbiosis • Antibiotic overusage • Family history
- 8. 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
- 9. • Confusion • Increasedappetite 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
- 10. DIFFERENTIAL DIAGNOSIS • Depression • Anxiety • Hyperactivity • Neurologic disease with resultant tremor • Heart disease • Drugs
- 11. DIAGNOSIS • Physical Examination •Laboratory Tests o Serum thyroxine (T4) assay o Serum triiodothyronine (T3) assay
- 12. • Other DiagnosticProcedures 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
- 13. GRAVES’ DISEASE Graves’ diseasealso known as Basedow’s disease
- 14. GRAVES’ DISEASE • Mostcommon 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
- 15. ETIOPATHOGENESIS • Graves’ diseaseis 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
- 16. • In patientswith Grave’s disease, eye signs may precede, coincide with or follow the hyperthyroidism • Sometimes similar eye signs are seen without a detectable thyroid abnormality
- 17. Pathology Activated T cellsinfiltrate orbital contents and stimulate fibroblasts, leading to: 1. Enlargement of extraocular muscles 2. Cellular infiltration of interstitial tissues 3. Proliferation of orbital fat and connective tissue
- 18. 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
- 19. CLINICAL FEARTURES • Slowlyand insidiously • Ophthalmopathy and dermatopathy • Ocular abnormalities
- 20. REFERENCES • Bartram T.Encyclopedia of Herbal Medicine. Dorset, England: Grace Publishers; 1995:422 • Text book of pathology • (Harsh Mohan), 5th edition
- 21.