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Graves Disease

Fozia Akhtar Ali, MD, Christina A. Majd, MD and Melida A. Juarez, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

Autoimmune disease in which thyroid-stimulating antibodies cause increased thyroid function; most common cause of hyperthyroidism. Classic findings are goiter, ophthalmopathy (orbito...

DIAGNOSIS

Hyperthyroid patients appear hypermetabolic with increased adrenergic tone. 

HISTORY

  • Tachycardia, palpitations

  • Tremor, restlessness

  • Hyperactivity, anxiety, emotional lability, insomnia

  • Sweating, ...

TREATMENT

MEDICATION

Goal is to correct hypermetabolic state with the fewest side effects and lowest incidence of posttreatment hypothyroidism. 

First Line

  • β-Blockers provide prompt control of adrenergic...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Monitoring is for the resolution of hyperthyroidism and for the development of hypothyroidism.

  • Check TSH and T4 levels every 1 to 2 months for th...

REFERENCES

1
Ren Z, Qin L, Wang JQ, et al. Comparative efficacy of four treatments in patients with Graves’ disease: a network meta-analysis. Exp Clin Endocrinol Diabetes.  2015;123(5):317–322. [V...

SEE ALSO

Algorithms: Anxiety; Cardiac Arrhythmias; Weight Loss, Unintentional 

CODES

ICD10

  • E05.00 Thyrotoxicosis w diffuse goiter w/o thyrotoxic crisis

  • E05.01 Thyrotoxicosis w diffuse goiter w thyrotoxic crisis or storm

  • E05.20 Thyrotoxicosis w toxic multinod goiter w/o thyrotoxic c...

CLINICAL PEARLS

  • Graves disease accounts for 60–80% of all cases of hyperthyroidism.

  • Potential morbidities of hyperthyroidism include ophthalmopathy, atrial fibrillation, congestive heart failure (CHF),...

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