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Graves' Disease I: Introduction

Graves' Disease I: Introduction

Graves' disease is an autoimmune disorder that causes hyperthyroidism, or overactivity of the thyroid gland. It results from autoantibodies called thyroid-stimulating immunoglobulins (TSIs), which bind to thyroid-stimulating hormone (TSH) receptors, leading to overstimulation of hormone production and a hypermetabolic state.EtiologyAlthough considered idiopathic, Graves’ disease has well-established contributing factors. There is a strong genetic component, with increased prevalence...

Graves Disease II: Pathophysiology

Graves Disease II: Pathophysiology

Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor,...

Hyperthyroidism I: Introduction

Hyperthyroidism I: Introduction

Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...

Hyperthyroidism II: Pathophysiology

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH...

Hypothyroidism II: Pathophysiology

Hypothyroidism II: Pathophysiology

Hypothyroidism is a disorder characterized by insufficient production of thyroid hormones, which regulate metabolism, energy balance, and multiple organ systems.TypesHypothyroidism is classified based on the level of dysfunction. Primary hypothyroidism results from intrinsic thyroid gland dysfunction, causing reduced hormone production despite normal or increased stimulation. Secondary hypothyroidism arises from inadequate thyroid-stimulating hormone (TSH) secretion by the pituitary. Tertiary...

Goiter

Goiter

Goiter refers to an abnormal enlargement of the thyroid gland that may appear as a diffuse goiter (uniform enlargement) or nodular (single or multiple nodules). Functionally, it is classified as nontoxic (normal/low hormone levels) or toxic (excess hormone production).PathophysiologyDiffuse thyroid enlargement typically results from prolonged stimulation by thyroid-stimulating hormone (TSH) or TSH-like agents, commonly seen in hypothyroidism or iodine deficiency. In contrast, in hyperthyroid...

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Minimal Invasive Resection of Large Retrosternal Thyroid Goiter

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Dissociative disorder due to Graves' hyperthyroidism: a case report.

Kaoru Mizutani¹, Katsuji Nishimura¹, Atsuhiro Ichihara²

¹Department of Psychiatry, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan.

General Hospital Psychiatry

|April 10, 2014

Summary

A young woman experienced dissociative symptoms, including amnesia for shoplifting and a suicide attempt, during a Graves' hyperthyroidism flare. This case highlights a rare psychiatric manifestation of autoimmune thyroid disease.

Keywords:

Dissociative amnesia Dissociative disorder Graves' disease Hyperthyroidism

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Area of Science:

Endocrinology
Psychiatry
Neuroscience

Background:

Graves' disease, an autoimmune disorder, commonly presents with psychiatric disturbances.
Dissociative disorders are characterized by disruptions in memory, consciousness, and identity.

Observation:

A 20-year-old Japanese woman with no prior psychiatric history developed dissociative symptoms.
These symptoms included amnesia for shoplifting incidents and a suicide attempt.
The onset of dissociative symptoms coincided with an exacerbation of her Graves' hyperthyroidism.

Findings:

This case suggests a potential link between Graves' hyperthyroidism exacerbation and dissociative disorder.
Dissociative symptoms may be an underrecognized psychiatric manifestation of autoimmune thyroid disease.

Implications:

Clinicians should consider dissociative disorder in patients with Graves' disease experiencing psychiatric symptoms.
Further research is needed to understand the neurobiological mechanisms connecting autoimmune thyroid disease and dissociative phenomena.
Recognizing this association can improve diagnostic accuracy and patient management.