graves'%20disease
GRAVES' DISEASE
Graves' disease is an autoimmune disorder that results into overproduction of thyroid hormones.
Thyrotoxicosis signs and symptoms include hyperactivity, irritability, insomnia, dysphoria, sweating, heat intolerance, palpitations, weakness, fatigue, weight loss despite increased appetite, diarrhea, steatorrhea polyuria, decreased libido, tachycardia, tremor, goiter, alopecia, gynecomastia, eyelid lag or retraction and rarely periodic paralysis.
Clinical features in thyrotoxic patient that suggests Graves's disease are ophthalmopathy, thyroid dermopathy, thyroid acropachy, diffuse goiter, antibodies to thyroid peroxidase or thyroglobulin and thyroid radionuclide scan demonstrating a diffuse goiter.

Follow Up

Radioactive Iodine Therapy
  • Follow up w/in 1-2 mth after therapy w/ assessment of free T4 & total T3
Patient Education
  • Instructions on radiation safety precautions immediately following treatment
Hypothyroidism (Permanent or Transient)
  • Transient
    • Usually occurs w/in 2 mth of therapy & lasts for 1-4 mth
    • May choose not to treat
  • Permanent
    • Treat w/ Levothyroxine
Worsening of Eye Disease
  • May occur w/ radioiodine therapy
  • Often transient
  • May be prevented w/ the administration of Prednisolone
Follow Up Exams
  • Every 4-6 wk until euthyroid & condition has stabilized
  • Then 3 mth, 6 mth, then annually based on physician’s judgment
Pharmacological therapy
Follow Up Exams
  • Every 2-3 mth x 2 yr
  • Then annually to check for recurrence

Surgical Therapy
Hypothyroid

  • Patients may become hypothyroid esp w/ total thyroidectomy
  • Treat w/ Levothyroxine
Follow Up Exams
  • As required
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