Basedow's disease: the symptoms

Graves' disease can be manifested by many symptoms, for example:

  • a stir,
  • sleep problems,
  • tiredness,
  • palpitations and / or disturbances of the heart rhythm,
  • trembling fingers or hands,
  • episodes of sweating,
  • the patient complains of being often hot,
  • weight loss despite similar eating habits or increased appetite,
  • goiter (swelling of the thyroid),
  • menstrual disorders on the female side,
  • erection problems on the male side,
  • a drop in libido,
  • thicker and redden skin, especially in the tibia or back of the foot (myxedema),
  • an exophthalmia. ..

Symptoms of exophthalmia

In 50% of the cases, Graves' disease has a more or less important impact on the eyes. The doctors then speak of exophthalmia : the eyeballs advance during the course of the Graves' disease and can even "go out" outside the orbit, which gives an impression of widening of the eyes. Result: the eyes look bigger, the patient looks permanently scared and may have trouble closing his eyes.

Exophthalmos can be unilateral or bilateral: in only one patient in ten, only one eye advances. In addition, the level of advancement of the eyeball may differ between the two eyes.

One in three develops a more or less severe form of exophthalmia affecting the physical appearance. Most often, it manifests itself in a lighter form that has almost no visible symptoms.

© Okapia

Exophthalmia: the syndrome of bulging eyes in a patient with Graves' disease (© Biophoto Associates / Science Source / OKAPIA)

Exophthalmia usually occurs between 6 to 12 months before hyperthyroidism or a few months after the onset of hyperthyroidism.

It is caused by the same antibodies that go against the thyroid: the antibodies bind to the receptors of TSH found on the cells of the thyroid, but also on the tissues in the eyeball. They cause inflammatory processes and other immune reactions that can cause swelling in the eyeball. It is these swellings that subsequently cause deformity of the eye, pain and other eye disorders or discomfort.

Here are the typical symptoms of exophthalmitis :

  • Protruding eyeballs,
  • Swelling behind the eye,
  • Difficulty to close the eye,
  • Frequent lachrymation,
  • Dry and irritated eyes,
  • Pressure or pain behind the eye,
  • Swollen eyelids,
  • Red or inflamed eyes,
  • Sensitivity to light,
  • Double vision,
  • Rarely: blurred vision, decreased vision.

Symptoms of myxedema (dermatopathy)

It happens (rarely) that some patients with Graves' disease develop myxedema. It is then a dermal infiltration - the appearance of an orange skin, hard and possibly brown or reddish - most often in the tibia (myxedema pretibial) or on the back of the foot. More rarely, similar symptoms can develop in the forearms or shoulders.

Symptoms of acropachia

Another rare symptom of Graves' disease is acropachia - also known as thyroid acropachydermia - a condition of the extremities that manifests as thickening of the tips of the fingers and toes, which appear to be swollen and distorted. . At the level of the hands, one speaks in particular of the fingers in the form of "drum stick", generally this phenomenon is accompanied by a bulge of the nails.

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