Endocrinology MCQ Answer 036

• Graves’ disease is the most common form of thyrotoxicosis.
  
• This syndrome consists of one or more of the following features: thyrotoxicosis, goiter, ophthalmopathy, dermopathy.
• It has an autoimmune etiology and a strong familial predisposition; approximately 15% of patients with Graves’ disease have a close relative with the disorder and approximately 50% of relatives of patients with Graves’ disease have circulating thyroid autoantibodies.
• Females are diagnosed with Graves’ disease five times more often than males; the peak age at diagnosis is 20 to 40 years of age.
  
• In Graves’ disease, T lymphocytes become sensitized to thyroid antigens and stimulate B lymphocytes to synthesize antibodies to these antigens. Thyroid autoantibodies, TgAB and TPO Ab, are found in both Hashimoto’s and Graves’ disease; TSH-Rab[stim] is unique to Graves’ disease.
  
• This autoantibody binds to the TSH receptor and stimulates the gland into hyperfunction.
  
• Triggers to acute episodes of Graves’ disease include: pregnancy and the postpartum period, iodine excess, lithium therapy, viral or bacterial infections and glucocorticoid withdrawal.

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