ABSTRACT
Graves’ disease is the most common cause of hyperthyroidism. The hyperthyroidism associated with Graves’ disease is caused by autoantibodies (TSAb) against thyroidstimulating hormone (TSH) receptors that stimulate thyroid cells. The exact mechanism of recognition of autoantigens and production of autoantibodies is, however, not known. The cause of Graves’ disease is generally thought to be multifactorial based on both genetic susceptibility and environmental factors (Table 1). In most patients the diagnosis of Graves’ disease is suspected based on diffuse thyroid enlargement, eye signs (ophthalmopathy), with characteristic clinical manifestations of hyperthyroidism. When the clinical manifestations are mild, early, or atypical, laboratory confirmation of hyperthyroidism (elevated serum thyroid hormone levels and decreased TSH) and presence of autoantibodies (thyroid peroxidase-microsomal antigen, antithyroglobulin, or TSH receptor antibody) are helpful to differentiate Graves’ disease from other causes of hyperthyroidism (1).
