Graves' Disease - Dubai Thyroid Clinic at DRHC

Dr. Rami Hamed Center in DHCC provides thyroid surgery in Dubai with the leading thyroid specialist in Dubai for complete care of thyroid diseases, including all diagnostic modalities and the latest non-surgical and surgical techniques available for the best outcomes.

Graves Disease

• It is an overproduction of thyroid hormones by the thyroid gland.
• It is an autoimmune disease with a 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.

Etiology

The exact etiology of Graves’ Disease is still unknown, but there are risk factors:

• Postpartum state
• Iodine excess
• Lithium therapy
• Bacterial and viral infections have been suggested as one of the causes
• Recently, genetic factors also play a role (HLA-B8, HLA-DR3, and HLADQA1*0501)

Mechanism:

T-helper cells stimulate 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 Graves’ disease.

Clinical Features

The clinical manifestations of Graves’ Disease can be divided into those related to:

• Hyperthyroidism
• Ophthalmopathy
• Dermopathy
• 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

1. TSH, FT3, FT4
2. Anti- Tg, anti- TPO which are elevated up to 75% of the patients.
3. TSH-R or thyroid-stimulating bodies (TSAb) are diagnostic of Graves’ Disease about 90%.

Radionuclide Imaging

1. With I-123 and elevated uptake, with diffusely enlarged gland confirms the diagnosis of Grave’s disease.
2. MRI scan of the orbits is useful in evaluating Graves’ Ophthalmopathy.

What are the treatment options?

Grave’s disease can be treated by any of the treatment modalities:

1. Anti-thyroid drugs:
2. Propylthiouracil (PTU): 100–300 mg three times daily.
3. Methimazole: 10–30 mg three times daily, then once daily
4. 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.

1. Surgical Treatment:
2. Absolutely Surgical Indications
3. Have confirmed cancer or suspicious thyroid nodules.
4. Young patients
5. Pregnant or desire to conceive soon after treatment
6. Have had severe reactions to anti-thyroid medications
7. Have large goitres causing compressive symptoms
8. Reluctant to undergo RAI therapy.
9. Relative Surgical Indications:
10. Patients, particularly smokers, with moderate to severe Graves’ Ophthalmopathy
11. Those desiring rapid control of hyperthyroidism with a chance of being euthyroid
12. Those demonstrating poor compliance with anti-thyroid medications.

*Advised to do a total or near-total thyroidectomy.

Dubai Thyroid Clinic - DRHC provides the best thyroid surgeon in Dubai and treatment for hypothyroidism, hyperthyroidism, thyroid cancer, thyroid disease, thyroidectomy, and thyroid surgery. DRHC provides advanced thyroid tests in Dubai.

Call us at DRHC to book your appointment at +97142798200