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Back to Endocrine Diseases
Graves-Basedow disease
Graves-Basedow disease is an immune disorder of the endocrine system
that stimulates and attacks the thyroid gland, being the most common cause
of hyperthyroidism. Also known simply as Graves' disease, it occurs most
frequently in women (8:1 compared to men) of middle age. Symptoms include
fatigue, weight loss and rapid heart beat. Because similar antibodies
to those attacking the thyroid also affect the eye, blurred vision and
eye irritation are also commonly reported. Graves' is a genetic disorder,
and while treatable with anti-thyroid medications or removal of the thyroid,
Graves' disease is incurable.
Definition
Graves-Basedow disease is a disorder characterized by a triad of hyperthyroidism,
goitre, and exophthalmos (bulging eyeballs).
Etiology unknown, it may be related to a malfunction of the immune system.
Female dominance, ratio 4: 1; onset is commonly in the third to fifth
decades of life. The severe form of exophthalmos occurs only in a minority
of patients with the disorder, and is also known as infiltrative opthalmopathy,
Graves' opthalmopathy, or Thyroid Eye Disease (TED).
Signs and symptoms
The symptoms include cardiac arrhythmias, increased pulse rate, weight
loss in the presence of increased appetite, intolerance to heat, elevated
basal metabolism rate, profuse sweating, apprehension, weakness, elevated
protein-bound iodine level, tremor, diarrhoea, headache, vomiting, eyelid
retraction, and stare.
Historical background
According to Jan-Gustaf Ljunggren, in an article in the Swedish journal
L?artidningen (1983; No 32-33), eponymic priority may be due to a Persian
physician. According to Ljunggren, more than eight hundred years ago the
Persian physician Sayyid Ismail Al-Jurjani seems to have noted the association
of goitre and exophthalmos, in Thesaurus of the Shah of Khwarazm, the
most famous of his five books, and the major medical dictionary of its
time.
The clinical picture was first noted by Caleb Hillier Parry (1755-1822)
in 1786 and reported in his posthumous collection of unpublished writings
in 1825. It was first described by the Italians Giuseppe Flajani (1741-1808)
in 1802 and Antonio Giuseppe Testa (1756-1814) in 1810. Robert James Graves
(1797-1853) of Ireland in 1835, and Karl Adolph von Basedow in 1840. The
clinical triad described by Basedow included goiter, exophthalmos, and
tachyardia. On the European Continent the term Basedow's disease is the
more common, while it is known as Graves' disease in the English-speaking
world.
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