Hyperthyroidism

Hyperthyroidism is a form of thyrotoxicosis in which there is excess thyroid hormone

synthesis and secretion
Etiology
1. GRAVES DISEASE
It is an autoimmune disease. Antibodies resembling TSH are formed and act on the thyroid and
stimulate production of
T3 & T4. It is associated with other autoimmune disease like type 1 diabetes, Addison’s disease,
Vitiligo.
There is diffuse enlargement of the thyroid gland. There is bruit and eye signs e.g., diplopia,
exophthalmos.

2. TOXIC ADENOMA
It is a benign tumor of the thyroid gland and it produces thyroxine. It is a solitary adenoma, which
means there will be
a lump in the thyroid which moves on swallowing.

3. TOXIC MULTINODULAR GOITER

There are multiple nodules.

4. SUBACUTE THYROIDITIS –
This is also known as De-quatrain’s thyroiditis
The cause is viral infection i.e., Upper Respiratory Tract Infection. The thyroid is usually painful and
enlarged.

5. iodine exposure

Anti‐TSH Receptor Antibodies

• Thyroid stimulating immunoglobulin (TSI)
– Bioassay that measures activation of cells that express TSH receptors

• Thyrotropin‐binding inhibitory immunoglobulin (TBII)

– Immunoassay that detects antibodies that bind to TSH receptor

Pathogenesis
Graves' disease, one of the autoimmune thyroid diseases, is caused by the production of
IgG autoantibodies directed against the thyrotropin receptor. These antibodies bind to
and activate the receptor, causing the autonomous production of thyroid hormones.
Despite recent improvements in our understanding of the cellular and molecular basis
of autoimmunity, our currently available treatments for Graves' disease have remained
largely unchanged over the last 50 years. Nevertheless, new concepts in immune system
regulation hold out the prospect in the future for intervention designed to modify, and
possibly cure, the underlying disease process.