Materiały źródłowe

• #1 Graves Disease: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/120619-overview

  Graves disease is the most common cause of hyperthyroidism in the United States. A study conducted in Olmstead County, Minnesota estimated the incidence to be approximately 30 cases per 100,000 persons per year. […] Among the causes of spontaneous thyrotoxicosis, Graves disease is the most common. Graves disease represents 60-90% of all causes of thyrotoxicosis in different regions of the world. In the Wickham Study in the United Kingdom, the incidence was reported to be 100-200 cases per 100,000 population per year. […] If left untreated, Graves disease can cause severe thyrotoxicosis. A life-threatening thyrotoxic crisis (ie, thyroid storm) can occur. […] Long-term excess of thyroid hormone can lead to osteoporosis in men and women. […] Hyperthyroidism increases muscular energy expenditure and muscle protein breakdown.

• #1 Graves’ disease – Wikipedia

  https://en.wikipedia.org/wiki/Graves%27_disease

  Graves’ disease occurs in about 0.5% of people. […] Graves’ disease data has shown that the lifetime risk for women is around 3% and 0.5% for men. […] It occurs about 7.5 times more often in women than in men and often starts between the ages of 40 and 60. […] It is the most common cause of hyperthyroidism in the United States (about 50 to 80% of cases).

• #1 Epidemiology of Graves’ Disease | SpringerLink

  https://link.springer.com/chapter/10.1007/978-1-4615-4407-4_2

  It has been estimated that over 3 million Americans currently have Graves disease of whom over 41,000 are children. […] Graves disease is associated with considerable morbidity, a decrease in quality of life and sufferers incur considerable health care costs. […] Yet the disease has been neglected by epidemiologists and as a result relatively little is known about its prevalence in the population and its social or biological antecedents.

• #1 Graves’ disease epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Graves%27_disease_epidemiology_and_demographics

  Graves disease is the most common cause of hyperthyroidism. It is estimated that it affects 20-50 cases per 100,000 persons yearly in the United States and it has a prevalence of about 0.4%. […] The annual incidence of Graves’ disease is about 20 to 50 cases per 100,000 persons. […] The annual incidence of Graves disease associated ophthalmopathy is 16 cases per 100,000 women and 3 cases per 100,000 men. […] The prevalence of Graves disease in the 1970s is estimated to be 0.4% in the United States. […] The incidence peaks between 30 and 50 years of age, but people can be affected at any age. […] Graves’ disease is more common in Caucasians than in Asians. […] Graves’ disease is more common among women than men. The lifetime risk is 3% for women and 0.5% for men.

• #1

  https://link.springer.com/article/10.1007/s12020-017-1306-5

  The age adjusted incidence of adult onset Graves disease in Sheffield, UK was 24.8 per 100,000 per year. […] Good epidemiological data on the disease is lacking as epidemiological studies focus on hyperthyroidism in general and not specifically on Graves disease. […] The overall crude incidence of Graves disease was 24.8 per 100,000 population per year. The age and gender adjusted incidence rates of adult Graves disease presenting to hospital are 24.9 and 24.8 per 100,000 per year, respectively. […] The incidence of Graves disease was 24.8 cases per 100,000 with an adjusted female to male ratio of 3.9:1. Studies have described incidence of thyroid disorders but studies specifically on Graves disease are rare.

• #1 Incidence and treatment outcomes of Graves’ disease in Thailand: a single-center retrospective observational study | Thyroid Research | Full Text

  https://thyroidresearchjournal.biomedcentral.com/articles/10.1186/s13044-022-00142-4

  The age-adjusted incidence of GD was 26.57 per 100,000 per year. […] The crude incidence rate of GD between 2014-2018 was 26.18 per 100,000 per year. […] The standard population has a female to male ratio of 1.07:1, giving the same sex adjusted incidence of 26.18 per 100,000 per year. […] The remission rate of ATD was 23.8%, similarly, the remission rate from the retrospective study of Thai patients in the private hospital was 30.7%. […] The remission rates in this study were 78.6% for RAI and 100% for surgery, less than those in the nationwide study in the US with 93% for RAI and 99% for surgery. […] Antithyroid drug was the preferred treatment modality for patients with Graves disease in Thailand; however, it is associated with less than 25% remission rate.

• #1 Graves’ Disease – Market Insight, Epidemiology, and Market Forecast – 2034

  https://www.giiresearch.com/report/del1625352-graves-disease-market-insight-epidemiology-market.html

  The total prevalent cases of Graves’ disease in the 7MM were ~7,134,600 in 2023. The prevalence of Graves’ disease in Japan is significantly lower than in Europe and the United States. […] Among the 7MM, the US accounted for approximately 48%, EU4 and the UK for 46%, and Japan for 6% of the total prevalent cases of Graves’ disease in 2023. […] As per the DelveInsight estimates, it has been found that there were approximately 3,720,200 diagnosed prevalent cases of Graves’ disease in the 7MM in 2023. […] In 2023, the manifestation of Graves’ disease in the US showed that Graves’ Ophthalmopathy captured the highest number of cases, i.e., approximately 584,400 cases. […] In 2023, the gender-specific diagnosed prevalent cases of Graves’ disease in Japan were approximately 80,450 cases for males and approximately 321,800 cases for females.

• #1 Graves’ disease: Epidemiology, genetic and environmental risk factors and viruses – PubMed

  https://pubmed.ncbi.nlm.nih.gov/32107168/

  Graves’ disease (GD) is the most common cause of hyperthyroidism in developed Countries. It is more common between 30 and 60 years; 5-10 times more frequent in women. The genetic predisposition accounts for 79% of the risk for GD, while environmental factors for 21%. […] Among environmental risk factors, smoking, iodine excess, selenium and vitamin D deficiency, and the occupational exposure to Agent Orange have been associated with GD. […] Many studies showed that HCV is associated with thyroid autoimmunity and hypothyroidism, in patients with chronic HCV hepatitis (CHC); a significant link has been shown also between HCV-related mixed cryoglobulinemia and risk for GD. […] Novel studies are needed about possible risk factors to reduce the occurence of GD in West Countries.

• #1 Graves Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448195/

  Graves disease is the most common cause of hyperthyroidism accounting for 60% to 80% of hyperthyroid cases. The overall prevalence of hyperthyroidism in the United States is 1.2% with an incidence of 20/100,000 to 50/100,000. It is most common in people ages 20 to 50 years. Graves disease is more common in women than men. Some data suggest its lifetime risk in women and men are 3% and 0.5%, respectively. As per the data from Nurses Health Study II (NHSII), the 12-year incidence among women ages 25 to 42 years was as high as 4.6/1000.[2] […] Graves disease is a systemic disorder that affects numerous organs; it’s presentations are diverse and hence the disorder is best managed by an interprofessional team. The natural history of Graves disease is well documented and eventually, all patients become hypothyroid and require hormone replacement therapy. Similarly, the ocular features of the disorder also become quiescent with time. Some patients may develop recurrence of hyperthyroidism after ablation and further therapy with radioactive iodine is needed. While the antithyroid drugs do control the symptoms, they do not cure the disease and hence relapses are common. The condition is best addressed with radioactive iodine. All patients need to be educated about the symptoms and signs of hyper-and hypothyroidism, as well as the side effects of the medications. More importantly, the patient should be urged to avoid over-the-counter medications that contain pseudoephedrine or ephedrine during treatment.

• #1 Graves’ disease: MedlinePlus GeneticsLock

  https://medlineplus.gov/genetics/condition/graves-disease/

  Graves’ disease affects about 1 in 200 people. The disease occurs more often in women than in men, which may be related to hormonal factors. Graves’ disease is the most common cause of thyroid overactivity (hyperthyroidism) in the United States. […] Graves’ disease is classified as an autoimmune disorder, one of a large group of conditions that occur when the immune system attacks the body’s own tissues and organs. […] People with Graves’ disease have an increased risk of developing other autoimmune disorders, including rheumatoid arthritis, pernicious anemia, systemic lupus erythematosus, Addison disease, celiac disease, type 1 diabetes, and vitiligo. […] The inheritance pattern of Graves’ disease is unclear because many genetic and environmental factors appear to be involved. However, the condition can cluster in families, and having a close relative with Graves’ disease or another autoimmune disorder likely increases a person’s risk of developing the condition.

• #1 Graves Disease: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/120619-overview

  In whites, autoimmune thyroid diseases are, based on linkage analysis, linked with the following loci: AITD1, CTLA4, GD1, GD2, GD3, HT1, and HT2. […] Susceptibility is influenced by genes in the human leukocyte antigen (HLA) region on chromosome 6 and in CTLA4 on band 2q33. […] As with most autoimmune diseases, susceptibility is increased in females. Hyperthyroidism due to Graves disease has a female-to-male ratio of 7-8:1. […] Typically, Graves disease is a disease of young women, but it may occur in persons of any age. The typical age range is 20-40 years.

• #1 Graves disease | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/graves-disease?embed_domain=external.radpair.com%252527%25255B0%25255Dfavicon.ico&lang=us

  There is a strong female predilection (F:M = 5:1), and is most common between 30 and 60 years. The incidence is 20 per 100,000 people. […] Pediatric Graves disease accounts for 5% of all cases (incidence 5 per 100,000 children). It is more common in older adolescents. Children have a lower female prediction (F:M = 3.5:1). […] There is a 10x increased relative risk of the following autoimmune diseases: rheumatoid arthritis (the most common co-existing autoimmune disorder), pernicious anemia, systemic lupus erythematosus, Addison disease, celiac disease, vitiligo.

• #1 2022 European Thyroid Association Guideline for the management of pediatric Graves’ disease in: European Thyroid Journal Volume 11 Issue 1 (2022)

  https://etj.bioscientifica.com/view/journals/etj/11/1/ETJ-21-0073.xml

  Hyperthyroidism caused by Graves disease (GD) is a relatively rare disease in children. […] The overall incidence in children and adolescents is around 4.58/100,000 per year, but before age 15 years, the incidence is lower: 1 to 2.91/100,000 per year. GD is 3.4 times more common in girls than boys. […] Childhood GD accounts for 5% of all GD cases throughout life. […] GD incidence varies between countries and may be rising. […] The frequency of GO in pediatric GD patients is 27-63% and is similar to adults. […] The time between diagnosing thyroid dysfunction and the onset of eye signs is usually less than 6 months. […] Independent risk factors for GO are smoking, TSHRAb, stress, and high FT4 at diagnosis.

• #1 Is Graves disease hereditary? Genes, risk factors, and more

  https://www.medicalnewstoday.com/articles/is-graves-disease-hereditary

  Graves disease is the most common cause of hyperthyroidism, which refers to an overactive thyroid. The disease has a strong genetic component, and having a family member with Graves disease makes a person more likely to develop it. […] Twin studies show that genetic factors account for 60% to 80% of the risk of developing Graves disease, and environmental factors account for the remaining risk. […] A 2020 review reported that the likelihood of Graves disease occurring in identical twins ranges from 29% to 36%. In nonidentical twins, it is between 0% and 4%. This suggests that genetic factors play a significant role in developing Graves disease. […] Having another autoimmune condition may increase the risk of developing Graves disease. A 2018 study found that around 17% of people with this disease also had another autoimmune condition.

• #1 Epidemiology – Primary Care Notebook

  https://primarycarenotebook.com/pages/diabetes-and-endocrinology/graves-disease/epidemiology

  Graves’ disease is the commonest cause of hyperthyroidism […] females affected more than males in the ratio 5:1 […] peak incidence from 30-50 years of age […] may affect 2 to 5% of all females at some time […] association with HLA B8 and HLA DR3 in caucasians […] there is some evidence that significant life events, for example, divorce or bereavement, may precipitate the development of Graves’ disease […] there is an association with smoking.

• #1 Graves’ Disease

  https://www.thyroid.org/graves-disease/

  Graves disease is the most common cause of hyperthyroidism in the United States. It is 7-8 times more common in women than men. […] Graves disease is an autoimmune disease and has a genetic predisposition. However, no specific gene has been identified for screening to date.

• #1 Graves, disease in clinical perspective

  https://www.imrpress.com/journal/FBL/24/1/10.2741/4708/htm

  Graves’ disease (GD) is the most common cause for hyperthyroidism in iodine-replete areas. GD has an incidence of about 40/100.000 per year. GD is more common in women than in men and most frequently seen in patients between 30 to 50 years of age. […] Epidemiologic studies with seasonal and geographic variation indicate a possible role of infections (e.g. superantigens from Yersinia enterocolitica) in the pathogenesis of GD. […] The appearance of TRAbs is presumed to be highly specific for the diagnosis of GD. Therefore the diagnosis GD is confirmed by demonstrating elevated TRAbs.

• #1 Graves Disease: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/120619-overview

  A study by Folkestad et al reported Graves disease and toxic nodular goiter to be a risk factors for dementia. […] Maternal Graves disease can lead to neonatal hyperthyroidism by transplacental transfer of thyroid-stimulating antibodies. […] Elderly individuals may develop apathetic hyperthyroidism, and the only presenting features may be unexplained weight loss or cardiac symptoms such as atrial fibrillation and congestive heart failure. […] Boelaert et al investigated the prevalence of and relative risks for coexisting autoimmune diseases in patients with Graves disease (2791 patients) or Hashimoto thyroiditis (495 patients). The authors found coexisting disorders in 9.7% of patients with Graves disease and in 14.3% of those with Hashimoto thyroiditis, with rheumatoid arthritis being the most common of these (prevalence = 3.15% and 4.24% in Graves disease and Hashimoto thyroiditis, respectively).

• #1 Graves’ Ophthalmopathy: Epidemiology and Natural History

  https://www.jstage.jst.go.jp/article/internalmedicine/53/5/53_53.1518/_article

  Graves’ ophthalmopathy (GO) is an autoimmune disorder of the orbit that is clinically relevant in 25-50% of patients with Graves’ disease and 2% of patients with chronic thyroiditis. […] The age-adjusted annual incidence of clinically relevant GO is 16 per 100,000 population in women and 2.9 in men. […] Genetic, anatomic and environmental factors influence the development of GO. Aging, thyroid dysfunction, thyroid stimulating hormone (TSH) receptor antibodies, smoking and radioiodine treatment for hyperthyroidism also influence the development and course of GO.

• #1 Graves’ orbitopathy as a rare disease in Europe: a European Group on Graves’ Orbitopathy (EUGOGO) position statement | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/s13023-017-0625-1

  Graves orbitopathy (GO) is an autoimmune condition, which is associated with poor clinical outcomes including impaired quality of life and socio-economic status. Current evidence suggests that the incidence of GO in Europe may be declining, however data on the prevalence of this disease are sparse. The prevalence of GO in Europe is about 10/10,000 persons. The prevalence of other clinical variants is also low: hypothyroid GO 0.021.10/10,000; GO associated with dermopathy 0.15/10,000; GO associated with acropachy 0.03/10,000; asymmetrical GO 1.005.00/10,000; unilateral GO 0.501.50/10,000. […] GO has a prevalence that is clearly above the threshold for rarity in Europe. However, each of its clinical variants have a low prevalence and could potentially qualify for being considered as a rare condition, providing that future research establishes that they have a distinct pathophysiology.

• #1

  https://exonpublications.com/index.php/exon/article/view/graves-disease-public-education

  Graves’ disease is the most common cause of hyperthyroidism, affecting approximately 1 in 200 people. The condition is more prevalent in women than in men, with a female-to-male ratio of about 7:1. Graves’ disease can occur at any age, but it most commonly develops between the ages of 30 and 50. The prevalence of Graves’ disease varies by geographic region and ethnicity, with higher rates observed in populations with a high iodine intake. Genetic factors also play a role in the development of Graves’ disease, with individuals who have a family history of autoimmune thyroid disorders being at increased risk. Environmental factors, such as stress, smoking, and infections, may also contribute to the onset of the disease. […] Understanding Graves’ disease is essential for managing its symptoms and improving the quality of life for those affected.

• #1 Hyperthyroidism and Thyrotoxicosis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/767130-overview

  Graves disease is the most common form of hyperthyroidism in the United States, causing approximately 60-80% of cases of thyrotoxicosis. The annual incidence of Graves disease was found to be 0.5 cases per 1000 population during a 20-year period, with the peak occurrence in people aged 20-40 years. […] Toxic multinodular goiter (15-20% of thyrotoxicosis) occurs more frequently in regions of iodine deficiency. Most persons in the United States receive sufficient iodine, and the incidence of toxic multinodular goiter in the US population is lower than that in areas of the world with iodine deficiency. […] The incidences of Graves disease and toxic multinodular goiter change with iodine intake. Compared with regions of the world with less iodine intake, the United States has more cases of Graves disease and fewer cases of toxic multinodular goiters.

• #1 Graves’ Disease: Pathophysiology, Genetics and Management | IntechOpen

  https://www.intechopen.com/chapters/76867

  The thyroid levels remain normal or autoimmune hypothyroidism develops either in 10% of the persons with ophthalmopathy. […] In the Whickham study a population-based survey in England, the annual incidence of Graves Disease was approximately 80 per 100,000 women, with most other surveys reporting incidence rates ranging from 15 to 50 per 100,000 persons per year while as the annual incidence in English men was approximately eight to ten fold lower than women (10 per 100,000) in keeping with gender differences seen in other thyroid diseases. […] The incidence of Graves hyperthyroidism in area of particularly high iodine intake (Japan), has been reported to be as high as 200 cases per 100,000 general population. […] Similarly, following the introduction of iodine supplementation, an increase in the apparent incidence of GD have been reported, although in an area of mild to moderate iodine deficiency (Switzerland), a 33% reduction in the incidence of GD was associated with iodine supplementation.

• #1 Global epidemiology of hyperthyroidism and hypothyroidism | Nature Reviews Endocrinology

  https://www.nature.com/articles/nrendo.2018.18

  Thyroid disease is a global health problem that can substantially impact well-being, particularly in pregnancy and childhood. […] In advanced economies, the prevalence of undiagnosed thyroid disease is falling owing to widespread thyroid function testing and relatively low thresholds for treatment initiation. […] More studies are needed in developing countries, especially within Africa, to understand the role of ethnicity and iodine nutrition fluxes in current disease trends. […] In the developed world, the prevalence of undiagnosed thyroid disease is likely falling owing to widespread thyroid function testing and relatively low thresholds for treatment initiation. […] We also highlight the pressing need for detailed epidemiological surveys of thyroid dysfunction and iodine status in developing countries.

• #1

  https://journals.lww.com/md-journal/fulltext/2024/06140/global_research_landscape_and_emerging_trends_in.42.aspx

  Graves disease is a prevalent thyroid disorder and is the primary cause of hyperthyroidism. […] It affects approximately 3% of women and 0.5% of men globally. […] Over the past 2 decades, significant progress has been made in understanding the occurrence, development, and treatment of GD. […] The analysis revealed a noticeable increase in publications since 2017, suggesting a growing focus on GD research in recent years. […] Current research focuses primarily on clinical management, TSH receptors and thyroid hormones, autoimmunity and inflammation, Graves ophthalmopathy, thyroid nodules, and thyroid cancer. […] The top 10 countries collectively contributed 64.69% of all publications. […] The analyzed articles originated from 132 countries and regions, with the top 3 contributors being the US (n=2377), China (n=1315), and Italy (n=916), accounting for 35.75% of all publications.

• #1 SciELO Brazil – The change in the clinical presentation of Graves’ disease: a 30 years retrospective survey in an academic Brazilian tertiary center The change in the clinical presentation of Graves’ disease: a 30 years retrospective survey in an academi

  https://www.scielo.br/j/aem/a/j7xdbv4pR7zsS95w8g8KVNR/?lang=en

  Graves disease (GD) is currently the main cause of hyperthyroidism in young adults affecting around 0.5% of the global population. […] The majority of cases are seen in women aged 35 to 60, but the condition may manifest itself in any age. […] The number of smoking patients was smaller from 2007 to 2016 (28.7%) compared to 1986 to 2006 (42.8% p = 0.001). […] The literature has suggested that the classic clinical manifestation of GD (large goiters, intense orbitopathy and thyrotoxicosis) is perhaps no longer the most common phenotype in recent diagnosis. […] GO is the main extrathyroidal manifestation of GD and may become an unusual disorder following according to its decreasing in frequency in later years especially severe forms. […] In the last decade especially in western populations an important reduction in GO was seen mainly as a result of antismoking legislation.

• #1 Graves’ disease: Epidemiology, genetic and environmental risk factors and viruses

  https://ouci.dntb.gov.ua/en/works/lxGY3BV4/

  The present report provides a set of GO risk factors, which can be used as a precise tool for an individual GO risk assessment. […] The aim of the survey was to identify trends in presentation of GO to the European Group On Graves’ Orbitopathy (EUGOGO) tertiary referral centres and initial management over time. […] In 2019, there was a decrease of severe cases (9.8% vs 14.9; p<0.001), but no significant change in proportion of active cases (41.3% vs 36.6%; p 0.217). [...] We speculate that this might be linked to a broader awareness of the disease and faster and adequate delivered treatment.

• #1 Pregnancy in Women with Graves’ Disease: Focus on Fetal Surveillance | IntechOpen

  https://www.intechopen.com/chapters/75306

  Graves disease (GD) is one of the most common autoimmune conditions in women of reproductive age. […] Graves Disease is one of the most common causes of thyrotoxicosis in women of reproductive age. It has been reported in as much as 1 in 500 pregnancies but is more frequent in the years prior and after conception. […] Fetal and neonatal hyperthyroidism has been reported in 15% of infants of mothers with GD. […] A maternal TRAb serum concentration approximately 3 times the upper limit of normal for the assay in the second and third trimesters predicted neonatal hyperthyroidism with 100% sensitivity and 43% specificity. […] It is therefore recommended to take into consideration determining TRAb levels at the initial thyroid function assessment during early pregnancy for those with a history of GD and maybe even in those that present for the preconceptional visit. […] Maternal GD, like other autoimmune conditions can flare in the postpartum, therefore, the mother should also be under supervision.

• #1 Graves disease in infancy: a patient presentation and literature review in: Endocrinology, Diabetes & Metabolism Case Reports Volume 2021 Issue 1 (2021)

  https://edm.bioscientifica.com/view/journals/edm/2021/1/EDM20-0162.xml

  Graves disease (GD) is the most common cause of hyperthyroidism worldwide. The annual incidence of childhood hyperthyroidism is estimated to be 1 per 1,000,000 in children younger than 4 years of age without female predominance. […] The neonatal form of GD is seen in approximately 0.6% of children born to mothers with active or inactive GD. […] Although rare, the complications can be devastating, so identifying and treating GD in infants are vital. […] Autoimmune diseases are becoming more common in infancy. […] The disease self-resolves, generally by 6 months of life, as the infant clears the maternal antibodies. […] The incidence of neonatal hyperthyroidism among newborns of Graves disease patients treated with radioiodine therapy is documented. […] The development of autoimmune thyroid disease at a young age may be caused by an environmental insult in a child who is genetically predisposed.

• #1 Graves Disease | 5-Minute Pediatric Consult

  https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617739/all/Graves_Disease?q=Goiter

  Female male (4 to 5:1) […] 1015% of all childhood thyroid disorders […] Incidence increases with age, peaking in adolescence and in the 3rd to 4th decades. […] Rising incidence of pediatric cases in several countries over the past 15 years […] Higher prevalence of thyrotoxicosis among non-Hispanic blacks in the United States, age 12 to 49 years.

• #1 Graves disease in infancy: a patient presentation and literature review in: Endocrinology, Diabetes & Metabolism Case Reports Volume 2021 Issue 1 (2021)

  https://edm.bioscientifica.com/view/journals/edm/2021/1/EDM20-0162.xml

  The possibility of concomitant other autoimmune disorders must always be considered, as some studies have reported a significant association between autoimmune thyroid disease, GD and HT, with other autoimmune illnesses. […] The first-line therapy for GD in children less than 5 years old is methimazole. […] This report describes the youngest child to be diagnosed with GD in the published English literature. […] To enhance knowledge about GD in infancy, we propose maintaining a registry of cases with genetic studies, monitoring the disease and time course of TSI persistence, and correlating with a duration of illness.

• #1 Graves’ Disease: Pathophysiology, Genetics and Management | IntechOpen

  https://www.intechopen.com/chapters/76867

  GD with an annual incidence of 20 to 50 cases per 100,000 persons is the most common cause of hyperthyroidism. […] The incidence of GD peaks between 30 to 50 years of age, but people can be affected at any age. […] The lifetime risk for women is 3% and for men it is 0.5%. […] The risk of GD is not influenced by long-term variations in iodine intake, but rapid repletion can transiently increase the incidence. […] The GD-associated incidence of ophthalmopathy is 16 cases per 100,000 in women and in men it is 3 cases per 100,000 annually. […] It is more common in whites than in Asians. […] Older men develop severe ophthalmopathy more likely than younger persons. […] Subtle abnormalities are revealed in 70% of patients by orbital imaging with GD. […] In up to 50% of patients in specialized centres, clinically consequential ophthalmopathy is detected with GD, and as a consequence of corneal breakdown or optic neuropathy in 3 to 5% of such patients, sight is threatened.

• #1

  https://consensus.app/questions/graves-disease-and-hypothyroidism/

  Graves’ disease (GD) is the leading cause of hyperthyroidism in developed countries, predominantly affecting women aged 30 to 60 years. Genetic predisposition plays a significant role, accounting for 79% of the risk, while environmental factors contribute 21%. Key environmental risk factors include smoking, iodine excess, selenium and vitamin D deficiency, and exposure to certain chemicals like Agent Orange. Additionally, hepatitis C virus (HCV) infection has been linked to thyroid autoimmunity and hypothyroidism, particularly in patients undergoing interferon-alpha treatment. […] TSH-blocking antibodies may cause hypothyroidism in approximately one third of Graves’ disease patients treated with antithyroid drugs, while autoimmune thyroiditis is comparable in the remaining two thirds. […] Graves disease is managed with antithyroid drugs or ablative treatments, but current treatments do not target the disease process, leading to high recurrence rates and lifelong hypothyroidism.

• #1

  https://consensus.app/questions/graves-disease-and-hypothyroidism/

  Patients with hyperthyroid Graves’ disease may develop hypothyroidism later due to autoimmune thyroiditis or the appearance of antibodies that block TSH stimulation. […] Regulatory T cells play a role in the progression of hyperthyroid Graves’ disease to Hashimoto’s thyroiditis and hypothyroidism in humans.

• #1 Long-term management of Graves disease: a narrative review

  https://www.e-jyms.org/journal/view.php?doi=10.12701/jyms.2022.00444

  Graves disease (GD) is the most common cause of hyperthyroidism, accounting for more than 90% of cases in Korea. […] The remission rate of GD after ATD treatment is approximately 30% to 70%. […] Several clinical factors, such as male sex, young age, high thyrotropin receptor antibody (TRAb) levels, ophthalmopathy, and smoking, have been proposed as indicators of poor prognosis after ATD therapy. […] The long-term remission rate after ATD treatment in patients with GD is approximately 50%, ranging from 30% to 70%. […] In the United States, the remission rate was 20% to 30% after ATD treatment for 12 to 18 months, whereas in Europe, it was 50% to 60% after 5 to 6 years of treatment. […] A recent Korean study also demonstrated that the duration of ATD therapy was inversely associated with the relapse rate in patients with GD and that ATD treatment duration was an independent risk factor for relapse.

• #1

  https://journals.lww.com/md-journal/fulltext/2024/06140/global_research_landscape_and_emerging_trends_in.42.aspx

  The collaborative networks between institutions revealed significant interactions. […] The diagnostic protocol for GD is well-established. […] The treatment approaches for GD vary among countries and regions. […] The emergence of bibliometric theories and tools offers effective solutions to these challenges.

• #2 Hyperthyroidism and Thyrotoxicosis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/767130-overview

  Graves disease is the most common form of hyperthyroidism in the United States, causing approximately 60-80% of cases of thyrotoxicosis. The annual incidence of Graves disease was found to be 0.5 cases per 1000 population during a 20-year period, with the peak occurrence in people aged 20-40 years. […] Toxic multinodular goiter (15-20% of thyrotoxicosis) occurs more frequently in regions of iodine deficiency. Most persons in the United States receive sufficient iodine, and the incidence of toxic multinodular goiter in the US population is lower than that in areas of the world with iodine deficiency. […] The incidences of Graves disease and toxic multinodular goiter change with iodine intake. Compared with regions of the world with less iodine intake, the United States has more cases of Graves disease and fewer cases of toxic multinodular goiters.

• #2 Graves’ Disease

  https://www.thyroid.org/graves-disease/

  Graves disease is the most common cause of hyperthyroidism in the United States. It is 7-8 times more common in women than men. […] Graves disease is an autoimmune disease and has a genetic predisposition. However, no specific gene has been identified for screening to date.

• #2 Graves’ disease – Wikipedia

  https://en.wikipedia.org/wiki/Graves%27_disease

  Graves’ disease occurs in about 0.5% of people. […] Graves’ disease data has shown that the lifetime risk for women is around 3% and 0.5% for men. […] It occurs about 7.5 times more often in women than in men and often starts between the ages of 40 and 60. […] It is the most common cause of hyperthyroidism in the United States (about 50 to 80% of cases).

• #2 Graves’ disease: Epidemiology, genetic and environmental risk factors and viruses – PubMed

  https://pubmed.ncbi.nlm.nih.gov/32107168/

  Graves’ disease (GD) is the most common cause of hyperthyroidism in developed Countries. It is more common between 30 and 60 years; 5-10 times more frequent in women. The genetic predisposition accounts for 79% of the risk for GD, while environmental factors for 21%. […] Among environmental risk factors, smoking, iodine excess, selenium and vitamin D deficiency, and the occupational exposure to Agent Orange have been associated with GD. […] Many studies showed that HCV is associated with thyroid autoimmunity and hypothyroidism, in patients with chronic HCV hepatitis (CHC); a significant link has been shown also between HCV-related mixed cryoglobulinemia and risk for GD. […] Novel studies are needed about possible risk factors to reduce the occurence of GD in West Countries.

• #2 2022 European Thyroid Association Guideline for the management of pediatric Graves’ disease in: European Thyroid Journal Volume 11 Issue 1 (2022)

  https://etj.bioscientifica.com/view/journals/etj/11/1/ETJ-21-0073.xml

  Hyperthyroidism caused by Graves disease (GD) is a relatively rare disease in children. […] The overall incidence in children and adolescents is around 4.58/100,000 per year, but before age 15 years, the incidence is lower: 1 to 2.91/100,000 per year. GD is 3.4 times more common in girls than boys. […] Childhood GD accounts for 5% of all GD cases throughout life. […] GD incidence varies between countries and may be rising. […] The frequency of GO in pediatric GD patients is 27-63% and is similar to adults. […] The time between diagnosing thyroid dysfunction and the onset of eye signs is usually less than 6 months. […] Independent risk factors for GO are smoking, TSHRAb, stress, and high FT4 at diagnosis.

• #2 Graves’ Disease: Causes and Risk Factors

  https://www.verywellhealth.com/graves-disease-hereditary-6499993

  Graves disease is the most common cause of an overactive thyroid gland (hyperthyroidism). […] A combination of genetic and environmental risk factors is believed to cause Graves disease. […] Research shows that hereditary factors account for 75% to 80% of a persons risk of developing Graves disease. […] Environmental factors account for 21% of the risk. Smoking, vitamin D deficiency, increased iodine intake, exposure to radiation, and viral infections are known to increase a persons risk of developing Graves disease, particularly if they have a genetic predisposition to the disorder.

• #2 Graves Disease: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/120619-overview

  In whites, autoimmune thyroid diseases are, based on linkage analysis, linked with the following loci: AITD1, CTLA4, GD1, GD2, GD3, HT1, and HT2. […] Susceptibility is influenced by genes in the human leukocyte antigen (HLA) region on chromosome 6 and in CTLA4 on band 2q33. […] As with most autoimmune diseases, susceptibility is increased in females. Hyperthyroidism due to Graves disease has a female-to-male ratio of 7-8:1. […] Typically, Graves disease is a disease of young women, but it may occur in persons of any age. The typical age range is 20-40 years.

• #2 Graves’ Ophthalmopathy: Epidemiology and Natural History

  https://www.jstage.jst.go.jp/article/internalmedicine/53/5/53_53.1518/_article

  Graves’ ophthalmopathy (GO) is an autoimmune disorder of the orbit that is clinically relevant in 25-50% of patients with Graves’ disease and 2% of patients with chronic thyroiditis. […] The age-adjusted annual incidence of clinically relevant GO is 16 per 100,000 population in women and 2.9 in men. […] Genetic, anatomic and environmental factors influence the development of GO. Aging, thyroid dysfunction, thyroid stimulating hormone (TSH) receptor antibodies, smoking and radioiodine treatment for hyperthyroidism also influence the development and course of GO.

• #2 Graves’ orbitopathy as a rare disease in Europe: a European Group on Graves’ Orbitopathy (EUGOGO) position statement | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/s13023-017-0625-1

  Graves orbitopathy (GO) is an autoimmune condition, which is associated with poor clinical outcomes including impaired quality of life and socio-economic status. Current evidence suggests that the incidence of GO in Europe may be declining, however data on the prevalence of this disease are sparse. The prevalence of GO in Europe is about 10/10,000 persons. The prevalence of other clinical variants is also low: hypothyroid GO 0.021.10/10,000; GO associated with dermopathy 0.15/10,000; GO associated with acropachy 0.03/10,000; asymmetrical GO 1.005.00/10,000; unilateral GO 0.501.50/10,000. […] GO has a prevalence that is clearly above the threshold for rarity in Europe. However, each of its clinical variants have a low prevalence and could potentially qualify for being considered as a rare condition, providing that future research establishes that they have a distinct pathophysiology.

• #2 Graves’ Disease: Pathophysiology, Genetics and Management | IntechOpen

  https://www.intechopen.com/chapters/76867

  The thyroid levels remain normal or autoimmune hypothyroidism develops either in 10% of the persons with ophthalmopathy. […] In the Whickham study a population-based survey in England, the annual incidence of Graves Disease was approximately 80 per 100,000 women, with most other surveys reporting incidence rates ranging from 15 to 50 per 100,000 persons per year while as the annual incidence in English men was approximately eight to ten fold lower than women (10 per 100,000) in keeping with gender differences seen in other thyroid diseases. […] The incidence of Graves hyperthyroidism in area of particularly high iodine intake (Japan), has been reported to be as high as 200 cases per 100,000 general population. […] Similarly, following the introduction of iodine supplementation, an increase in the apparent incidence of GD have been reported, although in an area of mild to moderate iodine deficiency (Switzerland), a 33% reduction in the incidence of GD was associated with iodine supplementation.

• #2 SciELO Brazil – The change in the clinical presentation of Graves’ disease: a 30 years retrospective survey in an academic Brazilian tertiary center The change in the clinical presentation of Graves’ disease: a 30 years retrospective survey in an academi

  https://www.scielo.br/j/aem/a/j7xdbv4pR7zsS95w8g8KVNR/?lang=en

  Graves disease (GD) is currently the main cause of hyperthyroidism in young adults affecting around 0.5% of the global population. […] The majority of cases are seen in women aged 35 to 60, but the condition may manifest itself in any age. […] The number of smoking patients was smaller from 2007 to 2016 (28.7%) compared to 1986 to 2006 (42.8% p = 0.001). […] The literature has suggested that the classic clinical manifestation of GD (large goiters, intense orbitopathy and thyrotoxicosis) is perhaps no longer the most common phenotype in recent diagnosis. […] GO is the main extrathyroidal manifestation of GD and may become an unusual disorder following according to its decreasing in frequency in later years especially severe forms. […] In the last decade especially in western populations an important reduction in GO was seen mainly as a result of antismoking legislation.

• #2 Graves’ disease: Epidemiology, genetic and environmental risk factors and viruses

  https://ouci.dntb.gov.ua/en/works/lxGY3BV4/

  The present report provides a set of GO risk factors, which can be used as a precise tool for an individual GO risk assessment. […] The aim of the survey was to identify trends in presentation of GO to the European Group On Graves’ Orbitopathy (EUGOGO) tertiary referral centres and initial management over time. […] In 2019, there was a decrease of severe cases (9.8% vs 14.9; p<0.001), but no significant change in proportion of active cases (41.3% vs 36.6%; p 0.217). [...] We speculate that this might be linked to a broader awareness of the disease and faster and adequate delivered treatment.

• #2 Global epidemiology of hyperthyroidism and hypothyroidism | Nature Reviews Endocrinology

  https://www.nature.com/articles/nrendo.2018.18

  Thyroid disease is a global health problem that can substantially impact well-being, particularly in pregnancy and childhood. […] In advanced economies, the prevalence of undiagnosed thyroid disease is falling owing to widespread thyroid function testing and relatively low thresholds for treatment initiation. […] More studies are needed in developing countries, especially within Africa, to understand the role of ethnicity and iodine nutrition fluxes in current disease trends. […] In the developed world, the prevalence of undiagnosed thyroid disease is likely falling owing to widespread thyroid function testing and relatively low thresholds for treatment initiation. […] We also highlight the pressing need for detailed epidemiological surveys of thyroid dysfunction and iodine status in developing countries.

• #2 Pregnancy in Women with Graves’ Disease: Focus on Fetal Surveillance | IntechOpen

  https://www.intechopen.com/chapters/75306

  Graves disease (GD) is one of the most common autoimmune conditions in women of reproductive age. […] Graves Disease is one of the most common causes of thyrotoxicosis in women of reproductive age. It has been reported in as much as 1 in 500 pregnancies but is more frequent in the years prior and after conception. […] Fetal and neonatal hyperthyroidism has been reported in 15% of infants of mothers with GD. […] A maternal TRAb serum concentration approximately 3 times the upper limit of normal for the assay in the second and third trimesters predicted neonatal hyperthyroidism with 100% sensitivity and 43% specificity. […] It is therefore recommended to take into consideration determining TRAb levels at the initial thyroid function assessment during early pregnancy for those with a history of GD and maybe even in those that present for the preconceptional visit. […] Maternal GD, like other autoimmune conditions can flare in the postpartum, therefore, the mother should also be under supervision.

• #2 Graves disease in infancy: a patient presentation and literature review in: Endocrinology, Diabetes & Metabolism Case Reports Volume 2021 Issue 1 (2021)

  https://edm.bioscientifica.com/view/journals/edm/2021/1/EDM20-0162.xml

  Graves disease (GD) is the most common cause of hyperthyroidism worldwide. The annual incidence of childhood hyperthyroidism is estimated to be 1 per 1,000,000 in children younger than 4 years of age without female predominance. […] The neonatal form of GD is seen in approximately 0.6% of children born to mothers with active or inactive GD. […] Although rare, the complications can be devastating, so identifying and treating GD in infants are vital. […] Autoimmune diseases are becoming more common in infancy. […] The disease self-resolves, generally by 6 months of life, as the infant clears the maternal antibodies. […] The incidence of neonatal hyperthyroidism among newborns of Graves disease patients treated with radioiodine therapy is documented. […] The development of autoimmune thyroid disease at a young age may be caused by an environmental insult in a child who is genetically predisposed.

• #2 Graves Disease: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/120619-overview

  Graves disease is the most common cause of hyperthyroidism in the United States. A study conducted in Olmstead County, Minnesota estimated the incidence to be approximately 30 cases per 100,000 persons per year. […] Among the causes of spontaneous thyrotoxicosis, Graves disease is the most common. Graves disease represents 60-90% of all causes of thyrotoxicosis in different regions of the world. In the Wickham Study in the United Kingdom, the incidence was reported to be 100-200 cases per 100,000 population per year. […] If left untreated, Graves disease can cause severe thyrotoxicosis. A life-threatening thyrotoxic crisis (ie, thyroid storm) can occur. […] Long-term excess of thyroid hormone can lead to osteoporosis in men and women. […] Hyperthyroidism increases muscular energy expenditure and muscle protein breakdown.

• #2 Graves Disease: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/120619-overview

  A study by Folkestad et al reported Graves disease and toxic nodular goiter to be a risk factors for dementia. […] Maternal Graves disease can lead to neonatal hyperthyroidism by transplacental transfer of thyroid-stimulating antibodies. […] Elderly individuals may develop apathetic hyperthyroidism, and the only presenting features may be unexplained weight loss or cardiac symptoms such as atrial fibrillation and congestive heart failure. […] Boelaert et al investigated the prevalence of and relative risks for coexisting autoimmune diseases in patients with Graves disease (2791 patients) or Hashimoto thyroiditis (495 patients). The authors found coexisting disorders in 9.7% of patients with Graves disease and in 14.3% of those with Hashimoto thyroiditis, with rheumatoid arthritis being the most common of these (prevalence = 3.15% and 4.24% in Graves disease and Hashimoto thyroiditis, respectively).

• #2

  https://consensus.app/questions/graves-disease-and-hypothyroidism/

  Patients with hyperthyroid Graves’ disease may develop hypothyroidism later due to autoimmune thyroiditis or the appearance of antibodies that block TSH stimulation. […] Regulatory T cells play a role in the progression of hyperthyroid Graves’ disease to Hashimoto’s thyroiditis and hypothyroidism in humans.

• #2 Long-term management of Graves disease: a narrative review

  https://www.e-jyms.org/journal/view.php?number=2746

  Graves disease (GD) is the most common cause of hyperthyroidism, accounting for more than 90% of cases in Korea. […] The remission rate of GD after ATD treatment is approximately 30% to 70%. […] Several clinical factors, such as male sex, young age, high thyrotropin receptor antibody (TRAb) levels, ophthalmopathy, and smoking, have been proposed as indicators of poor prognosis after ATD therapy. […] The long-term remission rate after ATD treatment in patients with GD is approximately 50%, ranging from 30% to 70%. […] In the United States, the remission rate was 20% to 30% after ATD treatment for 12 to 18 months, whereas in Europe, it was 50% to 60% after 5 to 6 years of treatment. […] A recent Korean study also demonstrated that the duration of ATD therapy was inversely associated with the relapse rate in patients with GD and that ATD treatment duration was an independent risk factor for relapse.

• #2 Long-term management of Graves disease: a narrative review

  https://www.e-jyms.org/journal/view.php?doi=10.12701/jyms.2022.00444

  Graves disease (GD) is the most common cause of hyperthyroidism, accounting for more than 90% of cases in Korea. […] The remission rate of GD after ATD treatment is approximately 30% to 70%. […] Several clinical factors, such as male sex, young age, high thyrotropin receptor antibody (TRAb) levels, ophthalmopathy, and smoking, have been proposed as indicators of poor prognosis after ATD therapy. […] The long-term remission rate after ATD treatment in patients with GD is approximately 50%, ranging from 30% to 70%. […] In the United States, the remission rate was 20% to 30% after ATD treatment for 12 to 18 months, whereas in Europe, it was 50% to 60% after 5 to 6 years of treatment. […] A recent Korean study also demonstrated that the duration of ATD therapy was inversely associated with the relapse rate in patients with GD and that ATD treatment duration was an independent risk factor for relapse.

• #2

  https://journals.lww.com/md-journal/fulltext/2024/06140/global_research_landscape_and_emerging_trends_in.42.aspx

  The collaborative networks between institutions revealed significant interactions. […] The diagnostic protocol for GD is well-established. […] The treatment approaches for GD vary among countries and regions. […] The emergence of bibliometric theories and tools offers effective solutions to these challenges.

• #3 Graves Disease: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/120619-overview

  Graves disease is the most common cause of hyperthyroidism in the United States. A study conducted in Olmstead County, Minnesota estimated the incidence to be approximately 30 cases per 100,000 persons per year. […] Among the causes of spontaneous thyrotoxicosis, Graves disease is the most common. Graves disease represents 60-90% of all causes of thyrotoxicosis in different regions of the world. In the Wickham Study in the United Kingdom, the incidence was reported to be 100-200 cases per 100,000 population per year. […] If left untreated, Graves disease can cause severe thyrotoxicosis. A life-threatening thyrotoxic crisis (ie, thyroid storm) can occur. […] Long-term excess of thyroid hormone can lead to osteoporosis in men and women. […] Hyperthyroidism increases muscular energy expenditure and muscle protein breakdown.

• #3 Graves Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448195/

  Graves disease is the most common cause of hyperthyroidism accounting for 60% to 80% of hyperthyroid cases. The overall prevalence of hyperthyroidism in the United States is 1.2% with an incidence of 20/100,000 to 50/100,000. It is most common in people ages 20 to 50 years. Graves disease is more common in women than men. Some data suggest its lifetime risk in women and men are 3% and 0.5%, respectively. As per the data from Nurses Health Study II (NHSII), the 12-year incidence among women ages 25 to 42 years was as high as 4.6/1000.[2] […] Graves disease is a systemic disorder that affects numerous organs; it’s presentations are diverse and hence the disorder is best managed by an interprofessional team. The natural history of Graves disease is well documented and eventually, all patients become hypothyroid and require hormone replacement therapy. Similarly, the ocular features of the disorder also become quiescent with time. Some patients may develop recurrence of hyperthyroidism after ablation and further therapy with radioactive iodine is needed. While the antithyroid drugs do control the symptoms, they do not cure the disease and hence relapses are common. The condition is best addressed with radioactive iodine. All patients need to be educated about the symptoms and signs of hyper-and hypothyroidism, as well as the side effects of the medications. More importantly, the patient should be urged to avoid over-the-counter medications that contain pseudoephedrine or ephedrine during treatment.

• #3 2022 European Thyroid Association Guideline for the management of pediatric Graves’ disease in: European Thyroid Journal Volume 11 Issue 1 (2022)

  https://etj.bioscientifica.com/view/journals/etj/11/1/ETJ-21-0073.xml

  Hyperthyroidism caused by Graves disease (GD) is a relatively rare disease in children. […] The overall incidence in children and adolescents is around 4.58/100,000 per year, but before age 15 years, the incidence is lower: 1 to 2.91/100,000 per year. GD is 3.4 times more common in girls than boys. […] Childhood GD accounts for 5% of all GD cases throughout life. […] GD incidence varies between countries and may be rising. […] The frequency of GO in pediatric GD patients is 27-63% and is similar to adults. […] The time between diagnosing thyroid dysfunction and the onset of eye signs is usually less than 6 months. […] Independent risk factors for GO are smoking, TSHRAb, stress, and high FT4 at diagnosis.

• #3 Graves’ Ophthalmopathy: Epidemiology and Natural History

  https://www.jstage.jst.go.jp/article/internalmedicine/53/5/53_53.1518/_article

  Graves’ ophthalmopathy (GO) is an autoimmune disorder of the orbit that is clinically relevant in 25-50% of patients with Graves’ disease and 2% of patients with chronic thyroiditis. […] The age-adjusted annual incidence of clinically relevant GO is 16 per 100,000 population in women and 2.9 in men. […] Genetic, anatomic and environmental factors influence the development of GO. Aging, thyroid dysfunction, thyroid stimulating hormone (TSH) receptor antibodies, smoking and radioiodine treatment for hyperthyroidism also influence the development and course of GO.

• #3 Pregnancy in Women with Graves’ Disease: Focus on Fetal Surveillance | IntechOpen

  https://www.intechopen.com/chapters/75306

  Graves disease (GD) is one of the most common autoimmune conditions in women of reproductive age. […] Graves Disease is one of the most common causes of thyrotoxicosis in women of reproductive age. It has been reported in as much as 1 in 500 pregnancies but is more frequent in the years prior and after conception. […] Fetal and neonatal hyperthyroidism has been reported in 15% of infants of mothers with GD. […] A maternal TRAb serum concentration approximately 3 times the upper limit of normal for the assay in the second and third trimesters predicted neonatal hyperthyroidism with 100% sensitivity and 43% specificity. […] It is therefore recommended to take into consideration determining TRAb levels at the initial thyroid function assessment during early pregnancy for those with a history of GD and maybe even in those that present for the preconceptional visit. […] Maternal GD, like other autoimmune conditions can flare in the postpartum, therefore, the mother should also be under supervision.

• #3 Graves disease in infancy: a patient presentation and literature review in: Endocrinology, Diabetes & Metabolism Case Reports Volume 2021 Issue 1 (2021)

  https://edm.bioscientifica.com/view/journals/edm/2021/1/EDM20-0162.xml

  Graves disease (GD) is the most common cause of hyperthyroidism worldwide. The annual incidence of childhood hyperthyroidism is estimated to be 1 per 1,000,000 in children younger than 4 years of age without female predominance. […] The neonatal form of GD is seen in approximately 0.6% of children born to mothers with active or inactive GD. […] Although rare, the complications can be devastating, so identifying and treating GD in infants are vital. […] Autoimmune diseases are becoming more common in infancy. […] The disease self-resolves, generally by 6 months of life, as the infant clears the maternal antibodies. […] The incidence of neonatal hyperthyroidism among newborns of Graves disease patients treated with radioiodine therapy is documented. […] The development of autoimmune thyroid disease at a young age may be caused by an environmental insult in a child who is genetically predisposed.

• #3 Graves Disease: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/120619-overview

  A study by Folkestad et al reported Graves disease and toxic nodular goiter to be a risk factors for dementia. […] Maternal Graves disease can lead to neonatal hyperthyroidism by transplacental transfer of thyroid-stimulating antibodies. […] Elderly individuals may develop apathetic hyperthyroidism, and the only presenting features may be unexplained weight loss or cardiac symptoms such as atrial fibrillation and congestive heart failure. […] Boelaert et al investigated the prevalence of and relative risks for coexisting autoimmune diseases in patients with Graves disease (2791 patients) or Hashimoto thyroiditis (495 patients). The authors found coexisting disorders in 9.7% of patients with Graves disease and in 14.3% of those with Hashimoto thyroiditis, with rheumatoid arthritis being the most common of these (prevalence = 3.15% and 4.24% in Graves disease and Hashimoto thyroiditis, respectively).

• #3 Long-term management of Graves disease: a narrative review

  https://www.e-jyms.org/journal/view.php?number=2746

  Graves disease (GD) is the most common cause of hyperthyroidism, accounting for more than 90% of cases in Korea. […] The remission rate of GD after ATD treatment is approximately 30% to 70%. […] Several clinical factors, such as male sex, young age, high thyrotropin receptor antibody (TRAb) levels, ophthalmopathy, and smoking, have been proposed as indicators of poor prognosis after ATD therapy. […] The long-term remission rate after ATD treatment in patients with GD is approximately 50%, ranging from 30% to 70%. […] In the United States, the remission rate was 20% to 30% after ATD treatment for 12 to 18 months, whereas in Europe, it was 50% to 60% after 5 to 6 years of treatment. […] A recent Korean study also demonstrated that the duration of ATD therapy was inversely associated with the relapse rate in patients with GD and that ATD treatment duration was an independent risk factor for relapse.

• #3 Long-term management of Graves disease: a narrative review

  https://www.e-jyms.org/journal/view.php?doi=10.12701/jyms.2022.00444

  Graves disease (GD) is the most common cause of hyperthyroidism, accounting for more than 90% of cases in Korea. […] The remission rate of GD after ATD treatment is approximately 30% to 70%. […] Several clinical factors, such as male sex, young age, high thyrotropin receptor antibody (TRAb) levels, ophthalmopathy, and smoking, have been proposed as indicators of poor prognosis after ATD therapy. […] The long-term remission rate after ATD treatment in patients with GD is approximately 50%, ranging from 30% to 70%. […] In the United States, the remission rate was 20% to 30% after ATD treatment for 12 to 18 months, whereas in Europe, it was 50% to 60% after 5 to 6 years of treatment. […] A recent Korean study also demonstrated that the duration of ATD therapy was inversely associated with the relapse rate in patients with GD and that ATD treatment duration was an independent risk factor for relapse.

• #4 Graves Disease: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/120619-overview

  Graves disease is the most common cause of hyperthyroidism in the United States. A study conducted in Olmstead County, Minnesota estimated the incidence to be approximately 30 cases per 100,000 persons per year. […] Among the causes of spontaneous thyrotoxicosis, Graves disease is the most common. Graves disease represents 60-90% of all causes of thyrotoxicosis in different regions of the world. In the Wickham Study in the United Kingdom, the incidence was reported to be 100-200 cases per 100,000 population per year. […] If left untreated, Graves disease can cause severe thyrotoxicosis. A life-threatening thyrotoxic crisis (ie, thyroid storm) can occur. […] Long-term excess of thyroid hormone can lead to osteoporosis in men and women. […] Hyperthyroidism increases muscular energy expenditure and muscle protein breakdown.

• #4 Pregnancy in Women with Graves’ Disease: Focus on Fetal Surveillance | IntechOpen

  https://www.intechopen.com/chapters/75306

  Graves disease (GD) is one of the most common autoimmune conditions in women of reproductive age. […] Graves Disease is one of the most common causes of thyrotoxicosis in women of reproductive age. It has been reported in as much as 1 in 500 pregnancies but is more frequent in the years prior and after conception. […] Fetal and neonatal hyperthyroidism has been reported in 15% of infants of mothers with GD. […] A maternal TRAb serum concentration approximately 3 times the upper limit of normal for the assay in the second and third trimesters predicted neonatal hyperthyroidism with 100% sensitivity and 43% specificity. […] It is therefore recommended to take into consideration determining TRAb levels at the initial thyroid function assessment during early pregnancy for those with a history of GD and maybe even in those that present for the preconceptional visit. […] Maternal GD, like other autoimmune conditions can flare in the postpartum, therefore, the mother should also be under supervision.

• #4 Graves disease in infancy: a patient presentation and literature review in: Endocrinology, Diabetes & Metabolism Case Reports Volume 2021 Issue 1 (2021)

  https://edm.bioscientifica.com/view/journals/edm/2021/1/EDM20-0162.xml

  Graves disease (GD) is the most common cause of hyperthyroidism worldwide. The annual incidence of childhood hyperthyroidism is estimated to be 1 per 1,000,000 in children younger than 4 years of age without female predominance. […] The neonatal form of GD is seen in approximately 0.6% of children born to mothers with active or inactive GD. […] Although rare, the complications can be devastating, so identifying and treating GD in infants are vital. […] Autoimmune diseases are becoming more common in infancy. […] The disease self-resolves, generally by 6 months of life, as the infant clears the maternal antibodies. […] The incidence of neonatal hyperthyroidism among newborns of Graves disease patients treated with radioiodine therapy is documented. […] The development of autoimmune thyroid disease at a young age may be caused by an environmental insult in a child who is genetically predisposed.

• #4 Long-term management of Graves disease: a narrative review

  https://www.e-jyms.org/journal/view.php?number=2746

  Graves disease (GD) is the most common cause of hyperthyroidism, accounting for more than 90% of cases in Korea. […] The remission rate of GD after ATD treatment is approximately 30% to 70%. […] Several clinical factors, such as male sex, young age, high thyrotropin receptor antibody (TRAb) levels, ophthalmopathy, and smoking, have been proposed as indicators of poor prognosis after ATD therapy. […] The long-term remission rate after ATD treatment in patients with GD is approximately 50%, ranging from 30% to 70%. […] In the United States, the remission rate was 20% to 30% after ATD treatment for 12 to 18 months, whereas in Europe, it was 50% to 60% after 5 to 6 years of treatment. […] A recent Korean study also demonstrated that the duration of ATD therapy was inversely associated with the relapse rate in patients with GD and that ATD treatment duration was an independent risk factor for relapse.

• #5 Pregnancy in Women with Graves’ Disease: Focus on Fetal Surveillance | IntechOpen

  https://www.intechopen.com/chapters/75306

  Graves disease (GD) is one of the most common autoimmune conditions in women of reproductive age. […] Graves Disease is one of the most common causes of thyrotoxicosis in women of reproductive age. It has been reported in as much as 1 in 500 pregnancies but is more frequent in the years prior and after conception. […] Fetal and neonatal hyperthyroidism has been reported in 15% of infants of mothers with GD. […] A maternal TRAb serum concentration approximately 3 times the upper limit of normal for the assay in the second and third trimesters predicted neonatal hyperthyroidism with 100% sensitivity and 43% specificity. […] It is therefore recommended to take into consideration determining TRAb levels at the initial thyroid function assessment during early pregnancy for those with a history of GD and maybe even in those that present for the preconceptional visit. […] Maternal GD, like other autoimmune conditions can flare in the postpartum, therefore, the mother should also be under supervision.

• #5 Graves disease in infancy: a patient presentation and literature review in: Endocrinology, Diabetes & Metabolism Case Reports Volume 2021 Issue 1 (2021)

  https://edm.bioscientifica.com/view/journals/edm/2021/1/EDM20-0162.xml

  Graves disease (GD) is the most common cause of hyperthyroidism worldwide. The annual incidence of childhood hyperthyroidism is estimated to be 1 per 1,000,000 in children younger than 4 years of age without female predominance. […] The neonatal form of GD is seen in approximately 0.6% of children born to mothers with active or inactive GD. […] Although rare, the complications can be devastating, so identifying and treating GD in infants are vital. […] Autoimmune diseases are becoming more common in infancy. […] The disease self-resolves, generally by 6 months of life, as the infant clears the maternal antibodies. […] The incidence of neonatal hyperthyroidism among newborns of Graves disease patients treated with radioiodine therapy is documented. […] The development of autoimmune thyroid disease at a young age may be caused by an environmental insult in a child who is genetically predisposed.

• #6 Pregnancy in Women with Graves’ Disease: Focus on Fetal Surveillance | IntechOpen

  https://www.intechopen.com/chapters/75306

  Graves disease (GD) is one of the most common autoimmune conditions in women of reproductive age. […] Graves Disease is one of the most common causes of thyrotoxicosis in women of reproductive age. It has been reported in as much as 1 in 500 pregnancies but is more frequent in the years prior and after conception. […] Fetal and neonatal hyperthyroidism has been reported in 15% of infants of mothers with GD. […] A maternal TRAb serum concentration approximately 3 times the upper limit of normal for the assay in the second and third trimesters predicted neonatal hyperthyroidism with 100% sensitivity and 43% specificity. […] It is therefore recommended to take into consideration determining TRAb levels at the initial thyroid function assessment during early pregnancy for those with a history of GD and maybe even in those that present for the preconceptional visit. […] Maternal GD, like other autoimmune conditions can flare in the postpartum, therefore, the mother should also be under supervision.

• #6 Graves disease in infancy: a patient presentation and literature review in: Endocrinology, Diabetes & Metabolism Case Reports Volume 2021 Issue 1 (2021)

  https://edm.bioscientifica.com/view/journals/edm/2021/1/EDM20-0162.xml

  Graves disease (GD) is the most common cause of hyperthyroidism worldwide. The annual incidence of childhood hyperthyroidism is estimated to be 1 per 1,000,000 in children younger than 4 years of age without female predominance. […] The neonatal form of GD is seen in approximately 0.6% of children born to mothers with active or inactive GD. […] Although rare, the complications can be devastating, so identifying and treating GD in infants are vital. […] Autoimmune diseases are becoming more common in infancy. […] The disease self-resolves, generally by 6 months of life, as the infant clears the maternal antibodies. […] The incidence of neonatal hyperthyroidism among newborns of Graves disease patients treated with radioiodine therapy is documented. […] The development of autoimmune thyroid disease at a young age may be caused by an environmental insult in a child who is genetically predisposed.

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