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Graves Disease

Angela Pauline Patawaran Calimag, MAN, RN, BSN, MD and Ruchita Patel, DO Reviewed 06/2022
 


BASICS

DESCRIPTION

Autoimmune disease in which thyroid-stimulating hormone receptor (TSHR) activation by thyrotropin receptor antibodies (TRAb) cause increased thyroid hormone secretion. Most common ca...

DIAGNOSIS

HISTORY

  • Tachycardia, palpitations

  • Tremor, restlessness

  • Hyperactivity, anxiety, emotional lability, insomnia

  • Sweating, heat intolerance

  • Pruritus, skin changes

  • Weight loss with increased appetite

  • Fat...

TREATMENT

GENERAL MEASURES

Choice of treatment modality is based on shared decision making between the medical provider and patient. The goal is to correct the hypermetabolic state with the fewest side...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Check TSH and T4 levels every 1 to 2 months for the first 6 months after treatment, then every 3 months for a year, and then every 6 to 12 month...

REFERENCES

1
Smith T, Hegedus L. Graves' Disease. N Engl J Med. 2016 Oct 20;375(16):1552-1565.
2
Ren  Z, Qin  L, Wang  JQ, et al. Comparative efficacy of four treatments in patien...

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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