Grave’s disease is an autoimmune disease caused by oversecretion of thyroid hormones by the diffuse tissue of the thyroid gland, which leads to poisoning with these hormones – thyrotoxicosis. The annual incidence is between 20 and 50 cases per 100.000 persons (Smith, 2016). Currently, Grave’s disease is considered a hereditary autoimmune disease that is transmitted by a multifactorial (polygenic) route. The disease is most common among women, epidemiological and environmental factors have a significant influence (Weetman, 2000). The factors provoking the development of the disease include mental trauma, nervous strain, age-related changes in the activity of the endocrine glands, infectious and inflammatory diseases, craniocerebral trauma, disease of the nasopharynx.
Characteristic symptoms of Grave’s disease are hyperthyroidism, goiter, and exophthalmos (bulging eyes). Due to the variety of functions of thyroid hormones, the disease has many clinical manifestations including cardiac, endocrine, dermatological, neurological, gastrointestinal, ophthalmological, and dental pathologies (Weetman, 2000). Thyrotoxic crisis poses a particular danger to life, with the development of the disease, severe damage to the heart, liver, and gonads develops. Although the disease requires clinical and laboratory confirmation, signs of ophthalmopathy or dermopathy are enough to confirm the diagnosis in a patient with diffuse goiter and hyperthyroidism (Weetman, 2000). However, for an accurate diagnosis, it is necessary to have biochemical abnormalities as well as characteristic clinical features.
Various methods are used to treat Grave’s disease, depending on the causes and conditions. Traditional medical treatment involves antithyroid drugs, which results in a remission process in 40-50% of patients (Smith, 2016). Radioiodine therapy is also used, which allows patients to recover from the symptoms of the disease within weeks. Indications for surgical treatment are allergic reactions or a persistent decrease in leukocytes, large goiter, and heart rhythm disturbances. The operation is performed only when the state of drug compensation is reached, since otherwise, a thyrotoxic crisis may develop in the early postoperative period. With adequate and timely treatment, the prognosis is favorable, yet, there is a chance of hypothyroidism development after surgical treatment.
References
Smith, T. (2016). Grave’s disease. The New England Journal of Medicine, 375(16), 1552-1565. Web.
Weetman, A. (2000). Grave’s disease. The New England Journal of Medicine, 343(17), 1236-1248. Web.