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Basedow syndrome (graves disease; hyperthyroidism; thyrotoxicosis; exophthalmic goiter; parry disease)    125


Basedow Syndrome (Graves Disease; Hyperthyroidism; Thyrotoxicosis; Exophthalmic Goiter;
Parry Disease)   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   &n 242b17c bsp;   



125

General: Diffuse toxic goiter; inherited as a simple autosomal recessive; penetrance greater in females; however, dominant mode of inheritance and variable penetrance are possible; uncommon in either sex before age 15 years.

Ocular: Exophthalmos; swelling of eyelids and discoloration of upper eyelids; lid lag (von Graefe); globe lag (Koeber); lid trembling on gentle closure (Rosenbach sign); reduced blinking (Stellwag); retraction of upper lid; difficulty in everting upper lid (Gifford sign); convergence weakness (Möobius); impaired fixation on extreme lateral gaze (Suker); possible external ophthalmoplegia (Ballet); Dalrymple sign (staring appearance); tearing; photophobia; epiphora; prolapse of lacrimal gland; neuroretinal edema; tortuous vessels; papilledema and papillitis; anisocoria; keratitis; increased intraocular pressure; increased intraocular pressure on upgaze; decreased visual acuity; enlargement of the extraocular muscles; increased volume of the extraorbital fat; superior rectus muscle enlargement; decreased venous outflow.

Clinical: Tachycardia; anxiety; insomnia; loss of weight; hyperhidrosis; restlessness; myocarditis (toxic); atrial fibrillation.

Cohen JS. Optic neuropathy of Graves' disease, hyperthyroidism, and ocular myasthenia gravis. Arch Ophthalmol 1973; 90:131.

Hirano T. Association of Graves' disease with Turner's syndrome. JAMA 1981; 246:2429.

Hudson HL, et al. Graves exophthalmos unrelated to extraocular muscle enlargement. Superior rectus muscle inflammation may induce venous obstruction. Ophthalmology 1991; 98:1495-l499.

Kendler DL, et al. The initial characteristics of Graves' orbitopathy vary with age and sex. Arch Ophthalmol 1993; 111:197-20l.

Kramar P. management of eye changes of Graves' disease. Surv Ophthalmol 197



4; 18:369-382.

Ravin JG, et al. Orbital radiation for the ocular changes of Graves' disease. Am J Ophthalmol 1975; 79:285-288.

Wartofsky L. Diseases of the thyroid, Graves' disease. In: Isselbacher KJ, et al., eds. Harrison’s Principles of Internal Medicine, 13th ed. McGraw-Hill, 1994:942-946.

Werner SC. Modification of the classification of the eye changes of Graves' disease. Am J Ophthalmol 1977; 83: 725-727.




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