Graves’ Disease
摘要
Graves’ disease (GD) is the leading cause of hyperthyroidism and a prototypical organ-specific autoimmune disorder. It is driven by the production of thyroid-stimulating hormone receptor antibodies (TRAb), resulting in unregulated thyroid hormone synthesis. This chapter presents a comprehensive and evidence-based review of GD, integrating current research with clinical practice to guide effective diagnosis and management. Key areas covered include global epidemiology, risk factors such as genetic susceptibility and environmental triggers, and recent insights into the immunopathogenesis involving TRAb, T-cell dysregulation, and cytokine-mediated pathways. The clinical spectrum of GD is described in detail, encompassing classic thyrotoxic symptoms, diffuse goiter, thyroid eye disease (TED), dermopathy, and rare manifestations such as acropachy. Diagnostic strategies—including thyroid function tests, antibody assays, and imaging techniques—are discussed alongside differential diagnoses. Management options are reviewed with a focus on individualized, risk-based approaches, encompassing antithyroid drugs, radioactive iodine, and surgical intervention. Special considerations are given to pediatric patients, pregnancy, and the management of TED. Emerging therapies, including novel immunomodulators and targeted biologics, are also explored. By bridging foundational knowledge with evolving clinical advancements, this chapter aims to support endocrinologists and healthcare professionals in delivering personalized, high-quality care to patients with Graves’ disease.