A look into…Graves’ Disease

Graves’ disease is an autoimmune disease of the thyroid gland, in which helper T cells autoreactive against the thyrotropin receptor activate B cells to produce anti-thyrotropin receptor antibodies. When antibodies with an activating effect on the receptor prevail, production of thyroid hormones is increased in an uncontrolled manner, and thyroid follicular cells undergo hypertrophy and hyperplasia.

This autoimmune process is probably due to an underlying genetic susceptibility (involving multiple genes associated with the function of both the thyroid and the immune system), epigenetic factors and superimposed environmental factors (viral infection, extreme stress, excessive iodine content in diet, some drugs and environmental pollutants).

Graves’ disease causes symptoms (weight loss, dyspnoea, tremor, anxiety, pruritus, etc.), thyroid-related signs (tachycardia, hypertension, goitre, altered mental status) and other signs (ophthalmopathy, dermopathy, acropachy), and its onset is usually acute.

The frequency of thyroid disorders differs between regions with different iodine availability, while differences in Graves’ disease ethnicity depend on the polymorphism of susceptibility genes in populations.

Untreated Graves’ disease significantly reduces the quality of life, has multiple complications and increases the risk of cardiovascular and psychiatric diseases. Hyperthyroidism is associated with a severe work disability and an increased risk of pregnancy loss and complications.

The available treatments include antithyroid drugs that block thyroid hormone synthesis (generally safe, with few side effects), radioactive iodine that causes damage to and death of thyroid cells (relatively safe and effective in goitre reduction, but eventually causes hypothyroidism), and thyroidectomy (provides a rapid relief of symptoms and restores euthyroidism, but does not improve ophthalmopathy).

The Epiomic™ database contains a forecast of the prevalent case load for Graves’ disease in males and females, as well as patient population broken down into goitre status at diagnosis and the first line treatment option. Moreover, a forecast of MCI patient populations with certain comorbidities is available.

Quick Fact

Smoking is a minor risk factor for Graves’ disease, but a major risk factor for Graves’ ophthalmopathy.