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Graves’ Disease

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The Thyroid and Its Diseases

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Abstract

Thyrotoxicosis refers to the clinical syndrome that results from increased thyroid hormone levels. The diagnosis can be confirmed by a suppressed thyroid-stimulating hormone (TSH) level and increased levels of free thyroxine (T4) and triiodothyronine (T3) on biochemical testing. The differential diagnosis is broad and includes Graves’ disease, which is the most common cause of thyrotoxicosis, followed by toxic nodular goiter and several other less commonly encountered conditions. Graves’ disease is an autoimmune thyroid disease and can present with extrathyroidal manifestations including ophthalmopathy, thyroid dermopathy, and thyroid acropachy. The goals of therapy in Graves’ disease are to restore a euthyroid state with antithyroidal drugs or achieve hypothyroidism with radioactive iodine or thyroidectomy in order to prevent complications of untreated Graves’. Each treatment has its risks and benefits, and therefore the treatment choice should be tailored to the specific clinical features as well as patient preferences. Due to the physiologic changes in pregnancy, special consideration must be given in accurately diagnosing, monitoring, and treating pregnant patients with hyperthyroidism. With proper treatment of Graves’ disease, relapse rates are low with definitive therapies compared to antithyroidal drugs, though all patients will require lifelong monitoring.

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Authors and Affiliations

  1. Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Josephine H. Li

  2. Division of Endocrinology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Natasha Kasid & James V. Hennessey

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  1. Josephine H. Li
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  2. Natasha Kasid
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  3. James V. Hennessey
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Correspondence to James V. Hennessey .

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Editors and Affiliations

  1. Department of Nuclear Medicine, Philipps University Marburg, Marburg, Germany

    Markus Luster

  2. Unit of Endocrinology Diabetes and Metabolism, Evgenidion Hospital, National and Kapodistrian University of Athens, Athens, Greece

    Leonidas H. Duntas

  3. Georgetown University School of Medicine, Washington, DC, USA

    Leonard Wartofsky

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Li, J.H., Kasid, N., Hennessey, J.V. (2019). Graves’ Disease. In: Luster, M., Duntas, L., Wartofsky, L. (eds) The Thyroid and Its Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-72102-6_22

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