Graves' disease natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
Overview
Natural History, Complications and Prognosis
Natural History
If left untreated it may lead to serious complications such as, thyroid storm, life threatening arrhythmias, orbitopathies, weight loss and even osteoporosis.
Complications
Cardiac complications
- Older patients are more vulnerable to develop cardiovascular complications comparing to young people.[1]
- When compared with people older than 60 years with a healthy thyroid, those who are hyperthyroid have three times the risk of atrial fibrillation.[2]
- Embolic stroke related to atrial fibrillation secondary to hyperthyroidism is significantly more prevalent than embolic stroke related to atrial fibrillation from non-thyroidal causes.[3]
- Thyroid-Associated Ophthalmopathy:
- Complications from surgery, including:
- Hoarseness from damage to the nerve leading to the voice box
- Low calcium levels from damage to the parathyroid glands (located near the thyroid gland)
- Scarring of the neck
- Eye problems (called Graves ophthalmopathy or exophthalmos
- Heart-related complications, including:
- Rapid heart rate
- Congestive heart failure (especially in the elderly)
- Atrial fibrillation
- Thyroid crisis (thyrotoxic storm), a severe worsening of overactive thyroid gland symptoms
- Increased risk for osteoporosis, if hyperthyroidism is present for a long time
- Complications related to thyroid hormone replacement
- If too little hormone is given, fatigue, weight gain, high cholesterol, depression, physical sluggishness, and other symptoms of hypothyroidism can occur
- If too much hormone is given, symptoms of hyperthyroidism will return
References
- ↑ Devereaux D, Tewelde SZ (2014). "Hyperthyroidism and thyrotoxicosis". Emerg. Med. Clin. North Am. 32 (2): 277–92. doi:10.1016/j.emc.2013.12.001. PMID 24766932.
- ↑ Sawin CT, Geller A, Wolf PA, Belanger AJ, Baker E, Bacharach P, Wilson PW, Benjamin EJ, D'Agostino RB (1994). "Low serum thyrotropin concentrations as a risk factor for atrial fibrillation in older persons". N. Engl. J. Med. 331 (19): 1249–52. doi:10.1056/NEJM199411103311901. PMID 7935681.
- ↑ Chen Q, Yan Y, Zhang L, Cheng K, Liu Y, Zhu W (2014). "Effect of hyperthyroidism on the hypercoagulable state and thromboembolic events in patients with atrial fibrillation". Cardiology. 127 (3): 176–82. doi:10.1159/000356954. PMID 24434544.