Toxic Diffuse Goiter (Graves Disease)

Toxic diffuse goiter (Graves disease) is an autoimmune hyperthyroidism caused by TSH-receptor-stimulating antibodies (TRAb). It presents in women aged 20-40 with diffuse goiter, hyperthyroid symptoms (palpitations, weight loss despite increased appetite, tremor, heat intolerance, sweating), infiltrative ophthalmopathy (exophthalmos, lid lag, diplopia), and pretibial myxedema. Untreated may progress to thyroid crisis; diagnosis by suppressed TSH, elevated free T4/T3, positive TRAb, diffuse uptake on scintigraphy.

Common Symptoms

Diffuse goiter; palpitations; weight loss; heat intolerance; tremor; sweating; exophthalmos; lid lag; pretibial myxedema; atrial fibrillation

Causes and Pathogenesis

TSH-receptor-stimulating IgG antibodies bind and activate the TSH receptor, causing continuous thyroid-hormone overproduction and diffuse thyroid hyperplasia; HLA-linked genetic susceptibility with environmental triggers (stress, infection, iodine).

Treatment

Thionamides (methimazole, PTU); beta-blockers for symptoms; radioiodine ablation; thyroidectomy; ophthalmopathy management (smoking cessation, selenium, steroids, orbital decompression if severe)

Preventive Measures

Smoking cessation (worsens ophthalmopathy); avoid excess iodine; regular TSH/TRAb monitoring; treat eye disease early.

Department to Visit

It is recommended to visit the Endocrinology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.