disease is a condition in which an autoantibody, the thyroid
stimulating immunoglobulin (TSI), binds to and stimulates the thyrotropin
receptor on thyrocytes. It is the most common cause of hyperthyroidism. Graves’
disease most commonly presents in the second to fourth decade, and is
more common in women.
to the typical clinical findings of thyrotoxicosis, patients with Graves ‘
disease usually exhibit a diffuse, non-tender, symmetrical goiter,
Ophthalamopathy apparent in 30% of patients, Dermatopathy, Acropathy with
clubbing of the fingers and toes, and frequently have detectable serum
antibodies to thyroid peroxidase (TPO) and less commonly to thyroglobulin
can be treated medically, with antithyroid drugs or radioactive iodine, or
surgically. Subtotal thyroidectomy results in a rapid cure of Graves
‘ disease in over 90% of cases. In addition, it eliminates compressive
symptoms from large goiter and does not appear to be any risk for worsening
of Graves Ophthalmopathy with no risk of mortality from thyroidectomy;
however, surgery is complicated by recurrent laryngeal nerve injury or permanent
hyperparathyroidism in 1% to 2% of patients. Transient hypocalcaemia,
bleeding, infection are also potential complications. Hypothyroidism may develop in up to
80%of patients in the year following surgical treatment.
and aim of
patients with Graves’ disease attending surgery outpatient clinic
were included in the study and offered operation.
were subjected to detailed history stressing
on age, Sex, drug intake and history of hormonal disease.
Then clinical examination of the thyroid
gland was carefully done to detect diffuse thyroid swelling, followed by
identify symptoms of toxic manifestation include heat intolerance,
palpitation, anxiety, fatigue, weight loss, irregular menses and Clinical sign
include tremor, tachycardia, lid lag, and warm, moist skin.
Then thyroid ultrasonography, a radioactive
iodine uptake (RAIU), thyroid isotope scan may be employed to provide a
definitive diagnosis. In Graves ‘ disease, the 24-hour RAIU is elevated
and scan reveals diffuse thyroidal radioiodine uptake, and thyroid profile is
defined as free triiodothyrnine (T3), free thyrnine (T4), thyroid
stimulating hormone (TSH) to diagnosis clinical and subclinical hyperthyroidism
Like other autoimmune diseases, graves’
disease tend to fluctuate in severity over time .it rarely enters remission
spontaneously, but may remit to response to antithyroid drug therapy.