Graves' disease

Graves’ disease (GD) is an autoimmune disorder in which autoantibodies against the TSH receptor (TRAbs) cause hyperthyroidism, and characterized by goiter and manifestations such as orbitopathy and more rarely pretibial myxedema. The etiology of GD is probably multifactorial, resulting from a combination of genetic and environmental factors. Smoking has been identified as a risk factor for developing GD. Familiar clustering and disease occurrence in twins suggest genetic factors in the pathogenesis of the disease. Elevated circulating free thyroid hormones are measured in patients with GD and, although not essential TRAb may also be measured to support the diagnosis of GD The therapy of GD aims at achieving stable restoration of euthyroidism with different therapeutic strategy including antithyroid drugs, radioiodine and total thyroidectomy. Restoration of permanent euthyroidism is attained in only about 30%-50% of patients after antithyroid therapy and therefore thyroid ablation with radioiodine (RAI) or surgery may be required.