MLO11 Coverstory

6. Discuss the use of laboratory tests to assess thyroid function in a pregnant GD patient. utoimmune diseases of the thyroid gland are the most common autoimmune diseases in humans, and encompass a wide spectrum of clinical presentations, ranging from Graves’ disease (GD), Graves’ ophthalmopathy (GO), Hashimoto’s thyroiditis, and idiopathic myxedema.1 GD is characterized by the production of autoantibodies directed against the receptor for the thyroid-stimulating hormone (TSH), frequently leading to increased thyroid function and clinical hyperthyroidism.2 GD is the most common cause of hyperthyroidism in iodinesufficient areas. It typically presents with enlargement of the thyroid gland (goiter), signs and symptoms of excessive thyroid function, ophthalmopathy (which is severe in 3% to 5% of cases), and less frequently pretibial myxedema and acropachy. GD affects approximately two of every 1,000 Americans every year, most of whom are women (male:female ratio is 1:7) in the third or fourth decade of life. Other immunological features of GD, common to other autoimmune thyroid diseases, are limphocytic infiltration of the thyroid, association with certain haplotypes of the major histocompatibility complex, familial occurrence, and presence of autoantibodies directed against other thyroid antigens such as thyroglobulin and thyro-peroxidase.3