Case Study of Graves' Disease

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Introduction

The case study selected focused on Grave’s disease an autoimmune disorder involving over production of thyroid hormones triidiothyronine (T3) and thyroxine (T4). In the United States it is the most common form of hyperthyroidism. The over taxed organ then becomes enlarged (goiter). This case study report will discuss the clinical progression and presentation of this disease, define and describe what an autoimmune disorder is, outline what clinical testing is performed for proper diagnosis, and the treatments involved for management of the disease and those afflicted.

An autoimmune disorder is when an individual’s own adaptive immune system begins producing antibodies against its own cells/tissues. This in turn causes a cascade of chemical responses between various immune components. This machinery ultimately leads to the destruction of these targeted cells/tissues. There are genetic mechanisms that are understood to predispose someone to certain autoimmune disorders. “Susceptibility is influenced by genes in the human leukocyte antigen (HLA) region on chromosome 6 and in CTLA4 on band 2q33” (Yeung, 2014).

Graves ’ disease (also known as toxic diffuse goiter) is when the body produces antibodies called thyroid-stimulating immunoglobulin (TSI) that attach to thyroid cells and mimic the role played by thyroid stimulation hormone (TSH). TSH naturally is regulated by the brain and pituitary gland in a negative feedback loop. Normally when T3 and T4 levels are low TSH is triggered and attaches to the thyroid to again make these hormones. Women are more likely to develop this disease than men (Yeung, 2014). This is presumed due to the fact they are more susceptible to physical manifestations of emotional stress and t...

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...rders: http://www.nlm.nih.gov/medlineplus/ency/article/000816.htm

Mizokami, T. e. (2005). Stress and Thyroid Autoimmunity . Thyroid, 1047-1055.

Saranac, L. e. (2011). Why is the Thyroid So Prone to Autoimmune Disease? Hormone Research in Pediatrics, 157-165.

Shoenfeld, Y. (2012). Sex, gender, and autoimmunity. Journal of Autoimmunity, J71-J73.

Strieder, T. G. (2003). Increased prevalence of antibodies to enteropathogenic Yersinia enterocolitica virulence proteins in relatives of patients with autoimmune thyroid disease. Clinical Experimental Immunology, 278-282.

Vita, R. e. (2009). A patient with stress-related onset and exacerbations of Graves disease. Nature Clinical Practice Endocrinology and Metabolism, 55-61.

Yeung, S.-C. J. (2014, April 21). Medscape Reference. Retrieved from Graves Disease: http://emedicine.medscape.com/article/120619-overview#showall

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