Basedow’s disease

Graves’ disease is one of the autoimmune diseases. It affects women five times more often than men. The reason is that certain substances in the immune system are directed against the body's own components and change or destroy them.

In the case of Graves' disease, so-called auto-antibodies develop against certain surface structures of thyroid cells (TSH receptors), which induce an increased production of hormones, which in turn often leads to thyroid enlargement and overactive leads (goiter, hyperthyroidism). Furthermore, these antibodies can also be directed against other body structures, whereby here mostly the small eye muscles and their connective tissue are affected and less often the anterior shin muscles. Subsequent immigration of certain immune cells (lymphocytes) leads to swelling of the affected areas. In the eye muscles, this can lead to the visible protrusion of the eyeball (endocrine orbitopathy) and a thickening of the front of the lower leg (pretibial myxedema). During the disease process, the eyeballs can progressively protrude from their sockets, increased tearing, reddening and burning, stare and double vision.

diagnosis

The clarification takes place via an exact survey of the medical history, determination of the thyroid values ​​including a complete antibody profile in the blood , ultrasound of the thyroid and finally via a scintigraphy . A scintigraphy can be used to visualize the storage behavior of the thyroid gland and thus correlate and diagnose thyroid diseases with the result of sonography (ultrasound). If there is evidence of involvement of the eye muscles, an ophthalmological examination must be carried out, possibly with ultrasound and /or magnetic resonance imaging of the eye sockets.

Course of disease

If Graves' disease is not recognized in time and treated appropriately, the aforementioned symptoms can worsen over time and lead to severe impairments. However, around 50% of all patients have a complete resolution of the symptoms at some point, in 20 to 40% even in the first year.

therapy

Unfortunately, Graves disease cannot be treated causally today. However, various tried and tested therapies are available to combat the symptoms. There are three methods of treating hyperthyroidism. Firstly, this is therapy with drugs that reduce hormone production (thyreostatics), secondly, the so-called "radioiodine therapy" , (this usually involves swallowing a capsule with radiating iodine The diseased thyroid cells are destroyed within a few days, but the healthy ones are not attacked) and, thirdly, the surgical removal of the thyroid if the other two procedures cannot be carried out or repeatedly fail. In severe cases, a cortisone preparation is used briefly to treat the eye condition or external irradiation of the diseased tissue is attempted. General measures are recommended here, such as wearing tinted glasses with wind protection and using tear substitute fluids.

prevention

Once the disease has been diagnosed, certain measures can help alleviate the symptoms. Smoking should be avoided , as this has been shown to increase the eye disease, as well as increased iodine intake through food (marine fish). In all "autoimmune diseases", the basic mental state of the patient seems to be of great importance, so that avoidance of psychological (stress) but also physical strain is indicated.