Graves’ Disease: Pathogenesis and Clinical Findings

B & T lymphocyte mediated autoimmunity attack TSH receptor -> Continuous stimulation of thyrotropin receptor by circulating autoantibodies -> Increased iodination of thyroglobulin, Thyroid gland hyperplasia

Note: B & T lymphocytes also attack other thyroid antigens (thyroglobulin, thyroid peroxidase, Na-I Symporter) but is believed to play little role in the etiology

Signs/Symptoms:

 - Pretibial myxedema

 - Fat pad: proptosis

 - Muscle: diplopia

 - Conjunctiva: conjunctivitis

 - Decr TSH

 - Goiter -> Hoarseness, Dysphagia, Thyroid gland bruit



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