Hyperthyroidism, Reference: Hyperthyroid, Harrison's Principles of Internal Medicine, Soheil Elahi, Islamic Azad University of Medicine- International Branch (IAUM-int)

1. Hyperthyroidism
Soheil Elahi
IAUMS-int University
Jun 2017
Reference: Harrison's Principles of Internal Medicine, 18th Edition Textbook

2. THYROTOXICOSIS
Graves' disease

3. Table 335-6 Causes of Thyrotoxicosis
Primary hyperthyroidism
Graves' disease
Toxic multinodular goiter
Toxic adenoma
Functioning thyroid carcinoma metastases
Activating mutation of the TSH receptor
Activating mutation of Gsa (McCune-Albright syndrome)
Struma ovarii
Drugs: iodine excess (Jod-Basedow phenomenon)
Thyrotoxicosis without hyperthyroidism
Subacute thyroiditis
Silent thyroiditis
Other causes of thyroid destruction: amiodarone, radiation, infarction of adenoma
Ingestion of excess thyroid hormone (thyrotoxicosis factitia) or thyroid tissue
Secondary hyperthyroidism
TSH-secreting pituitary adenoma
Thyroid hormone resistance syndrome: occasional patients may have features of thyrotoxicosis
Chorionic gonadotropin-secreting tumorsa
Gestational thyrotoxicosisa
THYROTOXICOSIS

4. Graves' Disease
EPIDEMIOLOGY

5. PATHOGENESIS
Graves' Disease

6. In Grav’s disease one of these signs should be
considered:
Graves' Disease

7. Pathogeneses
Graves' Disease

8. Pathogeneses
Graves' Disease

9. CLINICAL MANIFESTATIONS
Graves' Disease

10. Excludes the signs of ophthalmopathy and dermopathy specific for Graves' disease.
Table 335-7 Signs and Symptoms of Thyrotoxicosis (Descending Order of Frequency)
Signs and Symptoms of Thyrotoxicosis (Descending Order of Frequency)
Symptoms Signs
Hyperactivity, irritability, dysphoria
Heat intolerance and sweating
Palpitations
Fatigue and weakness
Weight loss with increased appetite
Diarrhea
Polyuria
Oligomenorrhea, loss of libido
Tachycardia; atrial fibrillation in the elderly
Tremor
Goiter
Warm, moist skin
Muscle weakness, proximal myopathy
Lid retraction or lag
Gynecomastia
THYROTOXICOSIS

11. Graves' Disease

12. cardiovascular manifestation
Graves' Disease

13. Graves' Disease

14. Graves' Disease

15. Graves' Disease

16. Graves' Disease

17. Graves' Disease

19. Graves' Disease

21. Graves' Disease

23. LABORATORY EVALUATION

24. Graves' Disease

25. Graves' Disease

26. Graves' Disease

27. Graves' Disease

28. Graves' Disease

29. Graves' Disease

30. Graves' Disease

31. Graves' Disease

32. Graves' Disease

33. Graves' Disease

34. Graves' Disease

35. Graves' Disease

36. Graves' Disease

37. Graves' Disease

38. Graves' Disease

39. Graves' Disease

40. Graves' Disease

41. Graves' Disease

42. Ophthalmopathy
Graves' Disease

43. Graves' Disease

44. Other Causes of
Thyrotoxicosis

45. Other Causes of
Thyrotoxicosis