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.

Graves' Ophthalmopathy

Mild/Moderate Disease
Non-pharmacological Therapy
  • Maintain euthyroid state
  • Smoking cessation
  • Avoid: Bright light, dust
  • Sleep w/ head elevated
  • Apply artificial tears & simple eye oint at night
Pharmacological therapy
  • Diuretic therapy
Severe Disease
  • Diplopia, optic neuropathy, or exposure keratitis
Non-pharmacological Therapy
  • Surgical decompression of orbits
  • Radiotherapy
Pharmacological therapy
  • Glucocorticoids
    • Oral Prednisolone or
    • Pulse IV Methylprednisolone
  • Cyclosporine
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