MRCP revision battle 35.1: Graves' disease
MRCP revision battle 35.2: Subacute (de Quervain's) thyroiditis
MRCP revision battle 35.3: Hashimoto's thyroiditis
MRCP revision battle 35.4: Drugs causing hypothyoidism
MRCP revision battle 35.5: Thyroid storm
MRCP revision battle 35.6: Anion gap
MRCP revision battle 35.1: Graves' disease
Graves' disease is an autoimmune condition which causes hyperthyroidism. Autoantibodies against the thyroid gland are present. This may be antithyroid peroxidase antibodies or antithyroglobulin antibodies (neither are specific as they may also found in Hashimotos) or TSH receptor antibody (specific)
Features of Graves' disease include:
- eye disease (see revision battle 29.2 to recap which features are Graves' disease specific)
- pretibial myxoedema - only found in Graves
- thyroid acropachy = clubbing, painful toe and finger swelling - also only in Graves
- diffuse thyroid enlargement
Associated with Graves' disease include:
- diabetes
- vitiligo
- Addisons
Treatment options for Graves are:
- titrate antithyroid drugs
- start at 40mg carbimazole
- continue for 12-18 months
- less side effects
- block and replace
- start at 40mg carbimazole, levothyroxine once euthyroid
- treat for 6 to 9 months
- more side effects
- radioiodine
on to battle 35.2...
