Thyroid Graves deseas 1

GRAVE'S DISEASE

      Grave’s disease manifests with hyperthyroidism (toxicity) predominantly in females below the age of 40 years. The etiology is unknown, but it has an autoimmune basis and psychic stress (Examination, marriage) have been known to precipitate the disorder. There is a family incidence and a close relationship to Hashimoto’s thyroiditis. There is also evidence of a disturbance of the immune system (Table 31.1)

      The factors found in the serum of patients with Grave’s disease are:

*     antimicrosomal antibodies (TMAb) and

*     anti-thyroglobulin antibodies (TgAb)

*     in addition there are antibodies against TSH

      receptor(TRAb)

*     and a stimulator of thyroid function (TSI)

      These antibodies sometimes disappear when the patient is treated with antithyroid drugs

12.1 Pathology

      The thyroid gland is moderately enlarged repesenting a diffuse hypertrophy and hyperplasia. On microscopy,

*     there is an increased height of the follicular cells

*     with decreased amount of colloid with scalloping and

*     interspersed areas of lymphocytic infiltration

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