<B>Graves Disease of the Thyroid </B>

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Graves Disease of the Thyroid

Etiology:

• Autoimmune process (see pathogenesis)

Pathogenesis:

• TSH receptor autoantibodies namely thyroid stimulating antibodies or thyroid stimulating immunoglobulin activate thyroglobulin production and release;
• thyrotropin binding inhibitor immunoglobulin mimics TSH activity

Epidemiology:

• 85% of cases of hyperthyroidism
• particularly in young women

General Gross Description:

• Diffusely enlarged gland
• Can weigh up to 200 g
• Richly vascular

General Microscopic Description:

• Depleted, scalloped, watery colloid
• Tall, columnar epithelial cells
• Hyperplasia of the follicular cells with multiple layers

Clinical Correlations:

• frequently triad of thyrotoxicosis with diffusely enlarged thyroid, opthalmopathy with edema, fibrosis and mucopolysaccharide deposition in the orbital tissues, and dermopathy (localized myxedema) over the lower legs
• treatment of the thyroid disease alone does not affect the opathalmopathy

References:
•Cotran Rs, Kumar V, Robbins SL. Robbins Pathologic Basis of Disease. 5th edition. W.B. Saunders. Philadephia 1994. pp. 1128-30