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Feature Article

Graves’ disease: the importance of TSH receptor antibodies

Natassia Rodrigo, Matti L. Gild, Diana L. Learoyd

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© doc stock/loenicker, p/diomedia.com

Abstract

Graves’ disease is the most common cause of hyperthyroidism and remains challenging to diagnose and treat. Regular measurement of thyroid stimulating hormone receptor antibody (TRAb) levels is essential to monitor disease activity and treatment duration. Medical management is universal at the time of diagnosis and antithyroid drugs are needed initially to restore euthyroidism.

Key Points

  • Thyroid stimulating hormone receptor antibody (TRAb) levels should be measured in all patients with thyrotoxicosis. This is useful for diagnosis and in guiding management.
  • Functional isotope thyroid scans may help clarify the cause of thyrotoxicosis.
  • Carbimazole is first-line therapy for patients with Graves’ disease, except in early pregnancy.
  • Beta blockers improve adrenergic symptoms and are helpful at the start of therapy.
  • Close monitoring of the patient with Graves’ disease during pregnancy and the postpartum period is vital.
  • Referral of the patient with Graves’ disease to an endocrinologist is advised, especially in women considering pregnancy and in patients who experience recurrence of the disease.

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© doc stock/loenicker, p/diomedia.com
© doc stock/loenicker, p/diomedia.com