Endocrinology Book

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Grave's Disease

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  1. See Also
    1. Thyroid Eye Disease
    2. Hyperthyroidism
  2. Epidemiology
    1. Most common cause of Thyrotoxicosis
  3. Signs: Specific to Grave's Disease
    1. See Hyperthyroidism
    2. Diffuse Goiter
    3. Audible bruit over Thyroid
    4. Infiltrative ophthalmopathy (Thyroid Eye Disease)
      1. Ophthalmoplegia
      2. Proptosis (Exophthalmos) in 50% of cases
      3. Periorbital swelling
    5. Dermopathy
      1. Pretibial Myxedema
  4. Lab
    1. Thyroid Stimulating Immunoglobulin (TSH receptor ab)
      1. Specific to Grave's Disease
      2. Linked with ophthalmopathy
      3. Usually not needed for diagnosis
      4. May be used to monitor effects of treatment
    2. Antithyroid Peroxidase Antibody negative
      1. Contrast with positive in Hashimoto's Thyroiditis
  5. Imaging
    1. Thyroid Ultrasound with doppler
      1. Thyroid hypervascularity with increased flow
    2. Thyroid uptake and scan
      1. High uptake on scan
  6. Management
    1. See Hyperthyroidism Management
    2. Referral to ophthalmology for ocular involvement

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