Dubai Thyroid Clinic
- It is an overproduction of thyroid hormones of the thyroid gland.
- It is an autoimmune disease with the female preponderance (5:1), and peak incidence between the ages of 40-65 years.
- It is the most common cause of hyperthyroidism approximately 60-80% of cases.
The exact etiology of Grave’s Disease is still unknown but there are risks factors:
- Postpartum state
- Iodine excess
- Lithium therapy
- Bacterial and viral infections have been suggested one of the cause
- Recently: genetic factors also play a role (HLA-B8, HLA- DR3, and HLADQA1*0501)
T-helper cells stimulates B lymphocytes, which produce antibodies directed against the thyroid hormone receptor (TRS). The thyroid-stimulating antibodies stimulate the thyrocytes to grow and synthesise excess thyroid hormone, which is a hallmark of Grave’s disease.
The clinical manifestations of Grave’s Disease can be divided into those related to:
- It is characterised by deposition of glycosaminoglycans leading to the thickened skin in the pretibial region and dorsum of the foot.
How we can diagnose Graves' Disease and what is the investigation assessed?
- Signs and symptoms
- Blood tests
- TSH, FT3, FT4
- Anti- Tg, anti- TPO which are elevated up to 75% of the patients.
- TSH-R or thyroid stimulating bodies (TSAb) diagnostic of Grave’s Disease about 90%.
- With I-123 and elevated uptake, with diffusely enlarged gland confirms the diagnosis of Grave’s disease.
- MRI scan of the orbits is useful in evaluating Grave’s Ophthalmopathy.
What are the treatment options?
Grave’s disease can be treated by any of the treatment modalities:
- Anti-thyroid drugs:
- Propylthiouracil (PTU) - 100-300 mg three times daily.
- Methimazole – 10-30 mg three times daily then once daily
- Radioactive Iodine Therapy (I-131) - the I-131 dose is calculated after a preliminary scan, and usually consists of 8-12 mCi administered orally.
*Medications should be advised by your treating physician.
- Surgical Treatment:
- Absolutely Surgical Indications
- Have confirmed cancer or suspicious thyroid nodules.
- Young patients
- Pregnant or desire to conceive soon after treatment
- Have had severe reactions to anti-thyroid medications
- Have large goitres causing compressive symptoms
- Reluctant to undergo RAI therapy.
- Relative Surgical Indications:
- Patients, particularly smokers, with moderate to severe Grave’s Ophthalmopathy
- Those desiring rapid control of hyperthyroidism with a chance of being euthyroid
- Those demonstrating poor compliance to anti-thyroid medications.
*Advised to do total or near total thyroidectomy.
Dubai Thyroid Clinic - DRHC provides treatment for hypothyroidism, hyperthyroidism, thyroid cancer, thyroid disease, thyroidectomy and thyroid surgery .