In Graves’ disease (synonyms: Graves’ disease; Graves’ goiter; Graves’ syndrome; Graves’ syndrome with exophthalmos; endocrine ophthalmopathy; endocrine orbitopathy (EO); exophthalmic goiter; exophthalmos in goiter; exophthalmos in thyrotoxicosis; Flajani disease; Graves’ disease; Hyperthyroidism in goiter; Hyperthyroidism in goiter; Hyperthyroidism with diffuse goiter; Graves’ type hyperthyroidism; Immunogenic hyperthyroidism; Latent hyperthyroid goiter; Graves’ disease; Graves’ disease with endocrine orbitopathy; Graves’ disease with endocrine orbitopathy and esotropia; Graves’ disease with endocrine orbitopathy and hypotropia; Graves’ disease with endocrine orbitopathy and eyelid retraction; Thyrotoxicosis with goiter; Thyrotoxic exophthalmos; Thyrotoxic exophthalmos; Toxic diffuse goiter; Toxic goiter; Toxic goiter diffusa; Von Basedow syndrome; Engl. Graves’ disease; ICD-10-GM E05.0: Hyperthyroidism with diffuse goiter) is a form of hyperthyroidism (hyperthyroidism) caused by an autoimmune disease (= immune hyperthyroidism). It is a hyperthyroidism (hyperthyroidism) induced by stimulating autoantibodies against the TSH receptor (TRAK). Along with thyroid autonomy (independent thyroid hormone production), Graves’ disease is the most common cause of hyperthyroidism.
Graves’ disease is often accompanied by goiter (thyroid enlargement) and/or ocular involvement (endocrine orbitopathy; this is the case in about 50% of Graves’ disease patients; > 90% of endocrine orbitopathies are associated with Graves’ disease). Approximately 20-30% of patients with endocrine orbitopathy develop exophthalmos, i.e., the eyeballs protrude. Depending on the extent, this can lead to psychological distress.
Sex ratio: Males to females is 1: 5-8.
Frequency peak: The disease occurs predominantly in the 2nd (3rd) and 4th decade of life. Approximately one-third of those with the disease are younger than 35 years of age.
The prevalence (disease incidence) is 2-3% for countries with sufficient iodine supply for women.
The incidence (frequency of new cases) is about 10-40 cases per 100,000 inhabitants per year (in Germany).
Course and prognosis: The prognosis of Graves’ disease varies from individual to individual. It may even be that the symptoms of the disease temporarily or permanently subside (remission: 50% of cases). In these cases, a relapse (recurrence) may occur after several years. Initially, therapy is usually conservative in the form of thyrostatic therapy (inhibition of thyroid function) lasting one to one and a half years. This leads to a cure in about 50% of cases, i.e. every second patient develops a recurrence (recurrence of the disease).By means of radioiodine therapy (RJT) or thyroidectomy (surgical removal of the entire thyroid gland) a definitive treatment of hyperthyroidism (hyperthyroidism) is possible. In both cases, affected individuals must subsequently take thyroid hormones daily for the rest of their lives to achieve normal hormone concentrations.
