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Graves’s disease

EPIDEMIOLOGY
Graves’ disease account  for 60- 80% of thyrotoxicosis. The prevalence varies among populations, reflecting genetic factors and iodine intake ( hight iodine intake is associated with an increased prevalence of Graves’s disease). Graves’ disease occurs in up to 2% of women but is one-tenth in frequent in men. The disorder rarely begins before adolescence and typically occurs between 20 and 50 years of age; it also occurs in the elderly.
CLINICAL MANIFESTATIONS
Signs and symptoms include features that are common to any cause of thyrotoxicosis as well as those specific for Graves’ disease. The clinical presentation depends on the severity of thyrotoxicosis, the duration of disease, individual susceptibility to excess thyroid hormone, and the patient’s age . In the elderly, features of thyrotoxicosis may be subtle or masked, and patients may present mainly with fatigue and weight loss, a condition know as apathetic thyrotoxicosis
Symptoms:

  1. hyperactivity, irritability, dysphoria (is a state of feeling unwell or unhappy; a feeling of emotional and mental discomfort as a symptom of discontentment, restlessness, dissatisfaction, malaise, depression, anxiety or indifference.)
  2. heat intolerance and sweating
  3. palpitations
  4. Fatigue and weakness
  5. Weight loss with increased appetite
  6. Diarrhea
  7. Polyuria
  8. Oligomenorrhea, loss of libido

Signs:

  1. Tachycardia, atrial fibrillation in the elderly
  2. Tremor
  3. Goiter
  4. Warm, moist skin
  5. Muscle weakness, proximal myopathy (Proximal muscle wasting and weakness is easily demonstratable.)
  6. Lid retraction or lag
  7. Gynecomastia

Excludes the signs of oththalmopathy and dermopathy specific for Graves’s disease.

LABORATORY EVALUATION
DIFFERENTIAL DIAGNOSIS

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