Graves disease can be diagnosed by symptoms alone; lab tests aren’t needed

• symptoms due to thyroid hormone

  • overproduction of hormone

• symptoms due to autoimmunity

  • goiter

  • ophthalmopathy

  • dermopathy

  • acropachy: thickening of the tuft of one of the fingers due to periostal hyperplasia

Graves ophthalmopathy

• protrusion of eye

• if patients looks up and down, this increases; this phenomenon is termed lid lag

• condition needs to be carefully watched because the patient can get permanent optic nerve damage

Myxedema

• orange-peel-like skin discoloration as a result of incorporation of mucopolysaccharide and glycosaminoglycans

• why does this happen? TSH-R is expressed at high levels in peripheral T4-converting fibroblasts, particularly in the pretibial region

• even worse: “elephantiasis variety”

Acropachy

• thickening of the skin around the fingernails

• onychomycosis: loosening of fingernails from fingers

Category: Pathology Notes