格雷夫斯病

格雷夫斯病是一种影响甲状腺的免疫系统疾病。它会导致身体产生过多的甲状腺激素。这种情况称为甲状腺功能亢进症。甲状腺激素影响身体的许多器官。因此，格雷夫斯病的症状也会影响这些器官。任何人都可能患上格雷夫斯病。但它在女性和30岁以上的人群中更为常见。格雷夫斯病的治疗有助于降低身体产生的甲状腺激素量并缓解症状。

格雷夫斯病的常见症状包括：感觉紧张和易怒；手或手指轻微震颤；对热敏感，出汗增多或皮肤温暖潮湿；体重减轻，尽管想吃更多；甲状腺肿大，也称为甲状腺肿；月经周期改变；无法勃起或保持勃起（称为勃起功能障碍），或性欲下降；排便频繁；眼睛突出——这种情况称为甲状腺眼病或格雷夫斯眼病；疲劳；皮肤增厚变色，主要在小腿或脚背（称为格雷夫斯皮肤病）；心跳加快或不规律（称为心悸）；睡眠不好。甲状腺眼病也称为格雷夫斯眼病。大约 25% 的格雷夫斯病患者有眼部症状。甲状腺眼病影响眼部周围的肌肉和其他组织。症状可能包括：眼睛突出；眼睛有沙粒感；眼睛压力或疼痛；眼睑肿胀或眼睑无法完全遮盖眼球（这称为眼睑回缩）；眼睛发红或发炎；畏光；视力模糊或复视；视力丧失。很少情况下，格雷夫斯病患者会出现皮肤变黑和增厚。它最常出现在小腿或脚背。皮肤质地像橘子皮。这称为格雷夫斯皮肤病。它是由皮肤中蛋白质积聚引起的。它通常是轻微的且无痛的。其他疾病也可能引起类似格雷夫斯病的症状。如果您有任何格雷夫斯病症状，请咨询您的医疗保健专业人员以获得及时的诊断。如果您有心脏相关症状，例如心跳加快或不规律，或者视力丧失，请立即就医。

其他一些疾病也可能引起与格雷夫斯病相似的症状。如果您有任何格雷夫斯病的症状，请咨询您的医疗保健专业人员以获得及时的诊断。如果您出现心脏症状，例如心跳过快或心律不齐，或者视力丧失，请立即就医。

格雷夫斯病是由人体的疾病抵抗免疫系统无法正常工作引起的。专家不知道为什么会发生这种情况。免疫系统会产生针对病毒、细菌或其他外来物质的抗体。在格雷夫斯病中，免疫系统会对颈部制造激素的腺体（称为甲状腺）细胞的一部分产生抗体。大脑底部的一个微小腺体，称为垂体，会产生一种控制甲状腺的激素。与格雷夫斯病相关的抗体称为促甲状腺激素受体抗体 (TRAb)。TRAb 接管了垂体激素的工作。这导致体内甲状腺激素比身体所需的更多。这种情况称为甲状腺功能亢进症。甲状腺眼病，也称为格雷夫斯眼病，是由眼睛后肌肉和组织中某些碳水化合物的积聚引起的。原因不明。它可能涉及相同的抗体，这种抗体可能导致甲状腺无法正常工作。甲状腺眼病通常与甲状腺功能亢进症同时出现或几个月后出现。但甲状腺眼病的症状可能在甲状腺功能亢进症开始前或后数年出现。也有可能患有甲状腺眼病而不患有甲状腺功能亢进症。

可能增加格雷夫斯病风险的因素包括：家族史。患有格雷夫斯病的人通常有甲状腺疾病或自身免疫性疾病的家族史。性别。女性比男性更容易患上格雷夫斯病。年龄。格雷夫斯病大多发生在30至60岁之间。另一种自身免疫性疾病。患有其他免疫系统疾病的人，如1型糖尿病或类风湿性关节炎，风险更高。吸烟。吸烟可能影响免疫系统，增加患格雷夫斯病的风险。吸烟且患有格雷夫斯病的人患甲状腺眼病的风险更高。

格雷夫斯病的并发症可能包括：妊娠健康问题。妊娠期格雷夫斯病可导致流产、早产、胎儿甲状腺问题和胎儿生长不良。它还可能导致孕妇心力衰竭和先兆子痫。先兆子痫会导致高血压和其他严重症状。 心脏疾病。未经治疗的格雷夫斯病可导致心律不齐以及心脏及其功能的变化。心脏可能无法向身体输送足够的血液。这种情况称为心力衰竭。 甲状腺风暴。这种格雷夫斯病罕见但致命的并发症也称为加速性甲状腺机能亢进或甲状腺危象。当严重甲状腺机能亢进未得到治疗或治疗不足时，更容易发生这种情况。 甲状腺风暴发生时，甲状腺激素的突然和剧烈升高会在体内引起许多影响。这些影响包括发烧、出汗、意识混乱、谵妄、严重虚弱、震颤、心律不齐、严重低血压和昏迷。甲状腺风暴需要立即就医。 骨质疏松。未经治疗的甲状腺机能亢进可导致骨骼脆弱、易碎——这种情况称为骨质疏松症。骨骼的强度部分取决于它们所含钙和其他矿物质的量。过多的甲状腺激素会使身体难以将钙吸收进入骨骼。

为了诊断格雷夫斯病，您的医疗专业人员可能会进行体格检查，并询问您的病史和家族史。检查可能包括：血液检查。血液检查显示体内促甲状腺激素 (TSH) 和甲状腺激素的水平。TSH 是垂体激素，它刺激甲状腺。格雷夫斯病患者的 TSH 水平通常低于正常水平，而甲状腺激素水平则高于正常水平。另一个实验室检查测量已知会导致格雷夫斯病的抗体的水平。如果结果没有显示抗体，则可能还有其他导致甲状腺功能亢进的原因。放射性碘摄取。身体需要碘来制造甲状腺激素。这项检查包括服用少量放射性碘。之后，特殊的扫描相机将显示有多少碘进入甲状腺。这项检查可以显示甲状腺吸收碘的速度。甲状腺吸收的放射性碘量有助于显示格雷夫斯病或其他疾病是否是甲状腺功能亢进的原因。这项检查可以与放射性碘扫描一起使用，以显示摄取模式的图像。梅奥诊所的护理我们梅奥诊所专家组的关爱团队可以帮助您解决与格雷夫斯病相关的健康问题。从这里开始更多信息梅奥诊所的格雷夫斯病护理CT 扫描 MRI

Graves' Disease Treatment Options

Graves' disease is a condition where the thyroid gland produces too much thyroid hormone. This excess hormone can cause various symptoms. Treatment focuses on reducing the amount of thyroid hormone produced and/or blocking its effects on the body. Several methods are available.

1. Radioactive Iodine Therapy:

This treatment involves taking radioactive iodine (radioiodine) by mouth. The radioiodine targets the cells in the thyroid that make hormones. Over time, these cells are destroyed, causing the thyroid gland to shrink. This usually leads to a gradual improvement in symptoms over several weeks or months.

• Potential Benefits: Reduces thyroid hormone production.
• Potential Side Effects: May slightly increase or worsen thyroid eye disease symptoms, though often these are mild and temporary. A temporary sore throat, or a slight increase in thyroid hormones is also possible. It's important to note this treatment is not suitable for pregnant or breastfeeding individuals. After treatment, you will likely need to take daily hormone replacement medication to maintain proper thyroid hormone levels.

2. Anti-thyroid Medications:

These medications prevent the thyroid from using iodine to create hormones. Common medications include propylthiouracil (PTU) and methimazole.

• Methimazole is often the first choice due to a lower risk of liver problems compared to PTU.
• PTU might be preferred during pregnancy's first trimester because of a slightly higher risk of birth defects with methimazole.
• Long-term use (often over a year) of these medications is often necessary to achieve and maintain effective control of hyperthyroidism.
• Potential Side Effects: Rash, joint pain, liver problems, and a reduction in white blood cells (which fight infection). If used alone, hyperthyroidism may return. These medications can be used before or after radioactive iodine therapy.

3. Beta-Blockers:

These medications don't reduce thyroid hormone production, but they do block the effects of the hormone on the body. This can quickly help ease symptoms like rapid heartbeat, tremors, anxiety, irritability, sweating, diarrhea, and muscle weakness.

• Common Beta-Blockers: Propranolol, Atenolol, Metoprolol, and Nadolol
• Important Note: Beta-blockers can trigger asthma attacks and may make managing diabetes more challenging.

4. Thyroid Surgery (Thyroidectomy):

In this procedure, the entire or a portion of the thyroid gland is surgically removed. This completely eliminates the source of excess hormone production.

• Lifelong Thyroid Hormone Replacement: After surgery, you'll need to take thyroid hormone replacement medication for the rest of your life.
• Potential Risks: Damage to vocal cords or parathyroid glands (which control calcium levels in the blood). The risk of complications is lower with surgeons experienced in thyroid surgery.

Treating Thyroid Eye Disease:

Eye problems associated with Graves' disease (thyroid eye disease) can vary in severity.

• Mild Symptoms: Artificial tears during the day and lubricating gels at night can help.
• Severe Symptoms: Treatment options include:
  • Corticosteroids: These powerful anti-inflammatory medications, given intravenously, can reduce swelling behind the eyes. Potential side effects include fluid retention, weight gain, high blood sugar, high blood pressure, and mood changes.
  • Teprotumumab (Tepezza): This medicine, given intravenously every three weeks, is used to target specific cells involved in eye inflammation. Potential side effects include hearing loss, nausea, diarrhea, muscle spasms, and high blood sugar.
  • Prisms: Special lenses may correct double vision.
  • Orbital Decompression Surgery: This surgery creates more space in the eye socket to reduce pressure on the eye. This is usually considered only for cases where the optic nerve is under pressure, which could lead to vision loss.
  • Orbital Radiotherapy: This less common treatment uses radiation to reduce eye inflammation. This is considered in cases where other treatments don't work or cause significant side effects.

Important Considerations:

• Symptoms may fluctuate: Even with treatment, symptoms of thyroid eye disease may worsen for a short period (3-6 months) before gradually improving.

Disclaimer: This information is for educational purposes only and should not be considered medical advice. Always consult with a healthcare professional for diagnosis and treatment of Graves' disease and its associated conditions.