Overview of etiology, diagnosis and management of Graves’ disease

Laura Grincevičiūtė1,  Justė Gaižauskaitė1 

1Lithuanian University of Health Sciences, Academy of Medicine, Faculty of Medicine, Kaunas, Lithuania


Graves’ disease is the most common cause of thyrotoxicosis. This is an autoimmune disorder. The immunopathogenesis of Graves’ disease is complex, but antibodies against the TSH receptor (TRAb) bind to TSH receptors on the surface of thyroid follicular cells, leading to continuous and uncontrolled thyroid stimulation causing hyperthyroidism. The incidence of Graves’ disease is 20 – 50 cases per 100,000 individuals each year and it usually affects patients aged 30–60 years with a female to male predominance. While 80% of susceptibility to autoimmune thyroid disease is attributed to genetic factors, the remaining 20% is from environmental exposures. Patients with Graves’ disease present with typical symptoms of thyrotoxicosis such as weight loss, fatigue, palpitations, tremor, anxiety, and tachycardia. Additionally, patients can present with a characteristic ophthalmopathy, thyroid dermopathy, and thyroid acropachy, which are autoimmune manifestations of Graves’ disease. Treatment involves anti-thyroid drugs usage, radio-iodine ablation and surgery in Graves’ disease.  A comprehensive understanding of the clinical manifestations as well as patient preferences will help physicians guide therapy for their patients, as each treatment has its own benefits and limitations and has to be assigned for each patient individually.

Keywords: Graves’ disease; Hyperthyroidism; Diagnosis; Treatment