IMR Press / FBL / Volume 24 / Issue 1 / DOI: 10.2741/4708

Frontiers in Bioscience-Landmark (FBL) is published by IMR Press from Volume 26 Issue 5 (2021). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with Frontiers in Bioscience.

Open Access Review
Graves, disease in clinical perspective
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1 Division for Specific Endocrinology, Medical Faculty, University of Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
Send correspondence to: Margret Ehlers, Division for Specific Endocrinology,MedicalFaculty, University of Duesseldorf,Moorenstr.5, 40225 Duesseldorf, Germany,Tel: 492118104860, Fax: 492118117082, E-mail: margret.ehlers@med.uni-duesseldorf.de
Front. Biosci. (Landmark Ed) 2019, 24(1), 33–45; https://doi.org/10.2741/4708
Published: 1 January 2019
Abstract

Graves’ disease (GD) is the most common cause for hyperthyroidism in iodine-replete areas. The disease is caused by the appearance of stimulating TSH receptor autoantibodies (TRAb) leading to hyperthyroidism. Blocking and neutral TRAb have, however, also been described. TRAb can be measured either by competition assays, assays using a bridge technology or bioassays (for discriminating stimulating vs. blocking antibodies). Therapy of GD with antithyroid drugs belonging to the group of thionamides is the first-line treatment to be continued for 12 up to 18 months. In case of relapse, thyroid ablative therapy including radioiodine therapy or thyroidectomy, respectively, should be performed. Risk factors for relapse are a large thyroid volume, persistence of high TRAb serum titer, smoking, and others. Within this review, we will give insights into the pathogenesis of GD including the pathogenesis of Graves’ ophthalmopathy. We also describe recent developments of TRAb measurement, which is used for the diagnosis of GD as well as for outcome prediction. Finally, we discuss therapy aspects as well as the important issue of GD and pregnancy.

Keywords
Thyroid
Graves’disease
Autoimmune Thyroiditis
TSH
Receptor
Autoantibodies
Relapse
Ophthalmopathy
Review
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