Hyperthyroidism

Grave's Disease (autoimmune) < 50 y/o

It is the most common cause of thyrotoxicosis and is typically seen in women aged 30-50 years.

Features

• typical features of thyrotoxicosis
• specific signs limited to Grave's (see below)

Features seen in Graves' but not in other causes of thyrotoxicosis

• eye signs (30% of patients)
  • exophthalmos
  • ophthalmoplegia
• pretibial myxoedema
• thyroid acropachy, a triad of:
  • digital clubbing
  • soft tissue swelling of the hands and feet
  • periosteal new bone formation

Autoantibodies

• TSH receptor stimulating antibodies (90%)
• anti-thyroid peroxidase antibodies (75%)

Thyroid scintigraphy

• diffuse, homogenous, increased uptake of radioactive iodine

Plummer's Syndrome: Toxic Multinodular Goiter >50 y/o - one area hot (iodine take-up)

Subclinical Hyperthyroidism