Neurological exam showed a fine tremor and fast return phase for deep tendon reflexes. Grave s disease is an autoimmune disease in which the immune system produces antibodies which stimulate the TSH receptors of the thyroid gland. The result is the non-suppressible overproduction of thyroid hormone, resulting in the clinical manifestations of hyperthyroidism. Grave s disease is frequently associatied with exophthalmus and swelling of the periorbital tissues. This infiltrative ophthalmopathy involves an increase in the mass of both retrobulbar connective tissue and extraocular muscles, the latter producing ophthalmoplegias.
Patients often complain about dry burning eyes.
Rarely there may be skin thickening on the legs referred to as pretibial myxedema. There is often a family history of both Grave s disease and autoimmune thyroiditis. She has a one month history of increased nervousness associated with a short temper, crying easily, and tremor. In addition she states she has lost 25 pounds without dieting, and is always hot. Her eyes protrude and feel dry.