Autoimmune Disease Symptoms : Hyperthyroidism in the Form of Graves’ Disease – Understanding Graves’ Disease
Autoimmune Disease Symptoms : What is Graves’ Disease? One of the most common disorders involving the thyroid is Graves’ disease. Since it was first described by the Irish physician Robert James Graves, it has become the leading cause of hyperthyroidism in the world.
Graves’ disease is an autoimmune disease caused by antibodies that mimic the effects of the hormone thyroid-stimulating hormone produced by the pituitary gland. These antibodies cause the thyroid gland to produce more and more thyroid hormone beyond the normal limits. This causes the body’s metabolism to speed up, resulting in the symptoms of hyperthyroidism.
Exactly how and why these antibodies are produced by the body, there is yet little explanation. However, it has been observed that Graves’ disease tends to run in the family so there might be a genetic predisposition to the production of the autoantibodies.
Another theory states that the production of the antibodies could be the result of a bacterial or viral infection as Graves’ disease tends to manifest later in life. One such organism believed to be involved in the development of Graves’ disease is the bacterium Yersinia enterocolitica. There is indirect evidence that there is a structural similarity between the bacterium and the human thyrotropin receptor, making the antibodies produced against Yersinia enterocolitica react with the thyroid gland. There is very little evidence to support this theory and it has been believed that the bacterium is not a direct cause of Graves’ disease but that it only serves to aid in the development of the disease in genetically susceptible individuals.
Spotting Graves’ Disease
Graves’ disease sports all the common signs and symptoms of a hyperthyroid patient but one such stands out against the rest to differentiate Graves’ disease from the rest — exophthalmos.
Exophthalmos is the protrusion of one or both of the eyeballs in most patients afflicted with Graves’ disease. This is due to the edematous swelling of the tissues at the back of the eyeballs and degenerative changes in the extraocular muscles. Immunoglobulins that may react with the eye muscles can be found in the blood of many of these patients. There is also reason to believe that exophthalmos in itself is an autoimmune process as the concentration of these immunoglobulins are highest in patients with increased levels of thyroid-stimulating immunoglobulins.
Patients with exophthalmos may suffer from impaired vision as the protrusion of the eyeball stretches the optical nerve. There may also be the risk of developing corneal irritation and infections because the eyes cannot fully close when the patient sleeps or blinks, causing the drying of the eyes.
Doctors who suspect Graves’ disease in patients may request thyroid blood tests to measure the levels of thyroid hormones and thyroid-stimulating hormone in the blood. Patients afflicted with Graves’ disease mostly have high levels of thyroid hormone and low levels of TSH. This is because the pituitary gland stops its secretion of TSH when the body’s levels of thyroid hormone go beyond normal limits.
Treatment of Graves’ Disease
Patients with Graves’ disease are usually treated with antithyroid drugs like propylthiouracil, methimazole, and carbimazole. Patients may also be treated with radioactive iodine to destroy the hypersecreting thyroid cells. In some cases, surgery may be necessitated although proper preparations may be made as surgical removal of the thyroid gland in hyperthyroid patients is dangerous.
Graves’ disease patients who must undergo surgical removal of the thyroid gland must first undergo several months of treatment with propylthiouracil until they reach normal basal metabolic rates, followed by large doses of iodine one to two weeks immediately before the operation to decrease the swelling and diminish the blood supply of the thyroid. Prior to the development of these preoperative procedures, mortality rate in thyroidectomy patients was rather high but now, it has been reduced to as low as 1 in every 1000 operations.
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