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Graves' disease

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Graves' disease is an autoimmune disease mediated by thyroid-stimulating IgG immunoglobulins directed against the TSH receptor, resulting in hyperthyroidism.

The autoimmune process involved in Graves' disease also typically is directed to soft tissues within the orbit - this results in inflammation and swelling, with periorbital oedema, proptosis, and ophthalmoplegia (Graves' ophthalmology).

The presence of pre-tibial myxoedema in association with hyperthyroidism is diagnostic but is uncommon, occurring in less than 5% of cases.

The natural history is one of alternating relapse and remission; less than 40% of patients have a single episode during their lifetime.

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