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An autoimmune disease in which thyroid-stimulating antibodies cause increased thyroid function. It is the most common cause of hyperthyroidism. Classic findings are goiter and ophthalmopathy (orbitopathy). Known as Basedow's disease in Europe.
- Overall prevalence of hyperthyroidism in the US is estimated to be 2% for women and 0.2% for men.
- More common in white and Hispanic populations in comparison to the black population.
- Graves disease accounts for 60–80% of all cases of hyperthyroidism.
- Predominant age: 30–40 years
- Female gender
- Postpartum period
- Stressful life events
- Medications: Iodine, amiodarone, lithium, highly active antiretroviral (HAART); rarely, immune-modulating medications (i.e., interferon therapy)
- Smoking (higher risk of developing ophthalmopathy)
Higher risk with personal or family history of any autoimmune disease, especially Hashimoto thyroiditis
Screening thyroid-stimulating hormone (TSH) in asymptomatic patients is not recommended. No data conclusively show that treatment of subclinical thyroid dysfunction improves quality of life or clinical outcome measures (1)[A].
- Excessive production of TSH receptor antibodies from B cells primarily within the thyroid, likely due to genetic clonal lack of suppressor T cells
- Binding of these antibodies to TSH receptors in the thyroid causes increased production of thyroid hormone.
- Binding to similar antigen in retro-orbital connective tissue causes ocular symptoms.
Commonly Associated Conditions
- Mitral valve prolapse
- Hypokalemic periodic paralysis