· It is also known as Grave’s disease or toxic diffuse goitre or endocrine disorder i.e. the most common cause of hyperthyroidism and thyrotoxicosis (effects of excess thyroid hormone action in tissues).
· Grave’s disease results in an abnormal over activity of the thyroid gland. The thyroid gland is stimulated to produce too much thyroid hormone. Increased too much thyroid hormone production leads to stimulation or quickening of the body’s metabolism.
· It is a form of hyperthyroidism characterized by enlargement of the thyroid gland, protrusion of the eyeballs, increased basal metabolic rate (BMR) and weight loss.
· Graves disease may also lead to serious, potentially life threatening complications.
· Over-activity of the thyroid gland associated with protrusion of the eyes, retraction of the upper lids and weakness of the eye movements. The hyperthyroidism causes excitability, a fast pulse rate, sweating and loss of weight.
· Exopthalmic may be severe as to threaten sight and the pressure in the eye sockets may have to be relieved surgically.
· They are found in aortic insufficiency, in chronic nephritis, in diffuse type of arteriosclerosis and in some cases of exopthalmic goitre.
· A disease of unknown cause characterized by enlargement of the thyroid gland. The thyroid gland may be slighty enlarged its normal size several times. The increased thyroid hormone production results in the symptoms and signs of hyperthyroidism. Some patients also experience exopthalmus (protrusion of the eyes) with eyelid retraction, edema of tissues surrounding the eyes, double vision and occasionally loss of vision, all of which are symptoms known as Graves’s opthalmopathy.
· Grave’s disease is an autoimmune disease, when the body reacts to its own tissues as though they were foreign substance. Patients with Grave’s disease produce antibodies that act on the thyroid to increase thyroid hormone production and thyroid size. These closely related antibodies may cause Grave’s opthalmopathy.
· Grave’s disease occurs in women 4-6 times as often as in men, it most often affects young to middle aged adults but can occur at all ages. The underlying case of Grave’s disease is not known, but there is genetic susceptibility to the disease and smoking is a risk factor, especially for the Grave’s opthalmopathy.
· Another characteristic of the disease is spontaneous remission of hyperthyroidism which occurs in 30-40% of the patients.
· Hyperthyroidism is treated with antithyroid drug, radioactive iodine or rarely surgical removal of the thyroid.
· Grave’s opthalmopathy occurs in approximately 25% of patients with Grave’s disease. It usually occurs as the patients are developing hyperthyroidism, but it can occur after hyperthyroidism.
· There is no simple, effective treatment for eye disease and it may persist for years. Patients with severe inflammation of the tissues that surround the eye or with impairment of vision. It may be treated with a glucocorticoid or surgical decompression of the orbits.
· Approximately 2% of the patients with Grave’s disease have localized myxedema. This is characterized by painless lumps composed of edematous subcutaneous tissue and thickening of the overlying skin in the lower legs or rarely the arms or trunk. Nearly all patients with localized myxedema had hyperthyroidism in the past and have severe opthalmopathy. The only effective treatment is application of glucocorticoid to the affected areas of skin.
· It is quite generally agreed; although with some dissatisfaction that thyroid gland is responsible, when abnormally active for the symptoms that characterize exopthalmic goitre.
Exopthalmic goitre is caused due to excessive secretion of thyroxine. Hyperthyroidism means the thyroid gland is overactive. A common cause is Grave’s disease in which the immune system produces antibody that act like TSH and stimulate the thyroid gland uncontrollably. The gland responds by producing an excessive amount of hormones. Grave’s disease can occur when the thyroid gland is attached by the body’s own immune system and causes it to become overactive and produce too much thyroid hormone.
Disease is characterized by following symptoms:
· Anxiety and irritability
· Insomnia or difficulty in breathing
· Protrusion of the eyes or bulging of eyes
· Retraction of the upper lids and weakness of the eye movements
· Fast pulse rate
· Loss of weight
· Enlargement of the thyroid gland
· Increased BMR (Basal Metabolic Rate).
· Excessive perspiration or shortness of breath and difficulty in breathing
· Irregular menstrual periods in women
· Increased stool frequency (with or without diarrhoea)
· Heat tolerance
· Diagnosis of exopthalmic goitre begins with taking through medical history including symptoms and completing a physical examination.
· A physician or health care provider observe a longer than normal thyroid gland in the neck.
· Blood tests are performed to determine levels of thyroid stimulating hormone (TSH) and the thyroid hormone thyroxine; it indicates that a thyroid gland is overactive.
· A nuclear scan of the thyroid gland may also be done to visualize the thyroid gland and determine how it is affected by Grave’s disease.
· Other tests may be performed to check the potential complications of Grave’s disease, such as heart disease.
· A chest X-rays may be done to evaluate the size of the heart and to check for fluid accumulation in the lungs that can occur with heart failure.
· An EKG may be done to diagnose abnormal heart rhythms.
· It is possible that a diagnosis of Grave’s disease can be misused or delayed because the symptoms can be associated with other conditions such as excessive caffeine use, enigma, aging or stress.
Prompt diagnosis and treatment of Grave’s disease can results in good prognosis and even a cure in some cases. With regular medical care and monitoring of Grave’s disease many people live active and normal life spans. Some of the treatments of Grave’s disease are discussed as follows:
· Bed rest
· Radium and X- rays helped bad cases, improving them clinically reducing the BMR.
· Ligation is of immense value in putting a patient into a condition where a thyroidectomy may be safely done.
Endocrine glands are ductless glands and their secretions are known as Hormones. They are chemical messengers which are secreted in trace amounts and affects the target organ of the body.
Pituitary gland release several hormones which regulate the functioning of different parts of the body. Growth hormone, PRL, TSH, ACTH, LH, FSH, MSH, oxytocin and vasopressin are the hormones released by the pituitary gland.
Thyroid glands are located in our neck region and secretes thyroxine, TCT and calcitonin hormone. On the other hand Parathyroid gland is located on the posterior side of thyroid gland and release PTH.
Adrenal glands are supra-renal glands which consists of two parts; cortex and medulla which releases certain hormones to regulate the process of human body.
Gonads,testes in male and ovary in female are the reproductive glands which secretes hormones that helps in the reproduction of male and female. Testes secrete androgen, inhibin,AMF and ovary release estrogen and progesterone.
Pancreas is a composite gland which function as both exocrine and endocrine gland. The endocrine pancreas consists of islets of langerhans. Alpha cells of pancreas secretes glucagon and beta cells release insulin.
Thymus gland is a lymphoid organ that secretes the peptide hormone thymosin. Thymus gland promotes the development of specific cell of the immune system called as T- lymphocytes.
Pineal gland is an endocrine gland found in the cerrebral ventricle in the brain midline. Pineal gland release melatonin hormone which controls circadian rhythm of the body.
Hypothalamus is the basal part of the brain which contain neuro-secretory cells called nuclei These nuclei produce hormones which regulate the functioning of pituitary hormones.
Hormones are natural organic substances that regulate growth, metabolism of the body. Protein hormones perform their action through extracellular receptors while mode of action of steroid hormones is through intracellular receptor.
Dwarfism is a condition in which the growth of the individual is very slow resulting in short stature. There are two types of dwarfism; Proportionate and Disproportionate dwarfism.
Acromegaly is a hormonal disorder that results from the excess of Growth hormone (GH)in the body. In Acromegaly pituitary produces excessive amounts of growth hormone.It is often diagnosed in middle aged adults and can result in serious illness and premature death.
Cretinism refers to severe hypothyroidism which is due to the deficiency of thyroid hormone. This is a medical condition present at birth and characterized by physical deformity, dwarfism and mental retardation..
Goitre is an enlarged thyroid gland that causes the neck to swell. The thyroid gland is controlled by the pituitary gland which prompts the thyroid to secrete hormones T4 and T3 by releasing TSH. Excessive stimulation of the thyroid gland by TSH can result in goitre.
It is preferably known as Diabetes Mellitus. It is a group of metabolic disorders in which the person has high blood glucose due to inadequate insulin production. There are three types of diabetes; type-1, type-2, Gestational diabetes.
Addison's disease also called as primary adrenal insufficiency, the adrenal glands do not produce enough hormone named cortisol and aldosterone. Cortisol helps in maintaining body response towards stress.
Hormones are chemical substances produced in one part of the body and carried by blood to target organ where it regulates the processes. Hormones regulate metabolic activities in various tissues.