The triad of hyperthyroidism, diffuse goiter, and ophthalmopathy was identified as a disease entity by Parry, 1 Graves, 2 and von Basedow3 in the first part of the 19th century. Although there is a strong temporal relationship between the onset of hyperthyroidism and eye symptoms, 4 many patients with hyperthyroidism do not experience clinical eye findings, and some patients with ophthalmopathy fail to manifest overt or subclinical signs of thyroid dysfunction.5-9 The absence of a consistent linkage between the thyroid disease and the eye disease has been an impediment to the identification of a common causal agent and to agreement on the optimal clinical management of the ophthalmopathy.
See also p 1098.
Graves' disease is considered to be autoimmune in origin. Thyroid-stimulating immunoglobulins stimulate the thyroid-stimulating—hormone receptor on the thyroid cell membrane.10 Some thyroid-stimulating immunoglobulins were once thought to cause ophthalmopathy, but that belief is no longer
FELDON SE. Graves' Ophthalmopathy: Is It Really Thyroid Disease? Arch Intern Med. 1990;150(5):948–950. doi:10.1001/archinte.1990.00390170010003
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