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Saturday, January 19, 2019

What is Grave's Disease and Its Symptoms

Grave's diseases is an endocrine disorder that is named after the doctor who first discovered a patient suffering from the condition in 1835. The doctor's name is Robert J. Graves. It is a type of autoimmune disorder of the thyroid gland where the thyroid gland produces and secretes excessive amounts of thyroid hormones leading to a condition called hyperthyroidism or thyrotoxicosis.

    Autoimmune disorders are those in which the body's natural defense mechanism - the immune system - attacks the healthy tissues of the body. In general it is seen that women suffer from more morbidity in adulthood, however, it is the men who have higher mortality. Grave's diseases is no exception where it is the women who are more predisposed towards developing the Grave's disease.

    Pathology of Grave's Disease

    The immune cells of the body produces antibodies which causes the thyroid gland to enlarge and swell up and produce thyroid hormones in excessive amounts than the normal needs of the body. These antibodies are called thyroid-stimulating immunoglobulins (TSIs).
    Thyroid Gland

    The TSIs bind to thyroid cell receptors which are the normal bindings sites for Thyroid Stimulating Hormones (TSHs). The function of TSH is to stimulate the thyroid cells to produce thyroid hormones.

    Normally, the secretion of the TSH is regulated by the body's normal homeostasis mechanism so that only sufficient amount of TSH is secreted to maintain the normal thyroid hormone secretion. However, by binding to the receptors of TSHs, the TSIs trick the thyroid cells into producing excessive thyroid hormones, thus leading to the production of hyperthyroidism.

    Symptoms of Grave's Disease

    Early symptoms of Grave's disease are somewhat non-specific and difficult to distinguish from other diseases. Common symptoms include:
    • Weight loss
    • Increased appetite
    • Anxiety, nervousness, irritability, tremors
    • Insomnia - difficulty sleeping
    • Chest pain, palpitations
    • Breathlessness
    • Irregular Menstruation
    • Goiter
    • Bulging eyes (Exopthalmos)
    • Visual disturbance (Double Vision)
    • Coarse skin

    Grave's Ophthalmology

    About 30% of people suffering from Grave's Disease have a condition called the Grave's Ophthalmology. Here the immune cells of the body attack the muscles and other tissues of the eyes leading to:
    • Bulging eyes (exopthalmos)
    • Gritty sensation
    • Pain in the eyes
    • Retracted eyelids
    • Light sensitivity
    • Double vision
    • Loss of vision

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    Causes of Grave's Disease

    Grave's disease is an autoimmune disorder with multiple risk factors:
    • Family History: Family history is a known risk factor of Grave's disease
    • Gender: Women are more likely to develop Grave's disease than men
    • Age: It usually develops in people younger than 40
    • Other autoimmune disorders: People with other autoimmune disorders such as type 1 diabetes or rheumatoid arthritis are more at risk of Grave's disease
    • Smoking: Smoking leads to immune dysregulation and may lead to the development of Grave's disease
    • Pregnancy: Pregnancy or recent childbirth increases the risk of developing Grave's disease
    • Emotional or physical distress: Stress is a triggering factor in those who are genetically susceptible to developing Grave's disease

    Complications of Grave's Disease

    The complications are:
    • Pregnancy Issues: It may lead to miscarriage, preterm labour, fetal thyroid dysfunction, poor fetal development, maternal heart failure and preeclampsia.
    • Heart Disorders: Untreated Grave's disease may lead to the development of arrhythmia, changes in the structure and function of the heart, and may lead to the development of congestive cardiac failure.
    • Thyroid storm: This is a life-threatening complication of Grave's disease also known as accelerated hyperthyroidism or thyrotoxic crisis. Thyroid storm requires immediate treatment. Here, sudden and drastic increase in thyroid hormones can produce a number of effects, including fever, profuse sweating, vomiting, diarrhea, delirium, severe weakness, seizures, markedly irregular heartbeat, yellow skin and eyes (jaundice), severe low blood pressure, and coma.
    • Fragile bones: Grave's disease leads to a condition called osteoporosis, where bones are weak and brittle.

    That's all for today!
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