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Previous Volume 358:2594-2605 June 12, 2008 Number 24 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.

A 23-year-old woman presents with palpitations. Over the past 6 months, she has reported loose stools, a 10-lb (4.5-kg) weight loss despite a good appetite and food intake, and increased irritability. She appears to be anxious and has a pulse of 119 beats per minute and a blood pressure of 137/80 mm Hg. Her thyroid gland is diffusely and symmetrically enlarged to . . . [Full Text of this Article]

The Clinical Problem

Strategies and Evidence

Evaluation

            Clinical Manifestations

            Laboratory Studies

            Imaging Studies

            Tests for Ophthalmopathy

            Other Diagnostic Studies

Therapy

Pharmacologic Therapy

Radioiodine Therapy

Surgery

Treatment for Ophthalmopathy

Graves' Disease and Pregnancy

Areas of Uncertainty

Guidelines from Professional Societies

Conclusions and Recommendations

Source Information

From the Veterans Affairs Greater Los Angeles Healthcare System, and the Departments of Medicine and Physiology, David Geffen School of Medicine at UCLA — both in Los Angeles.

An audio version of this article is available at www.nejm.org.

Address reprint requests to Dr. Brent at the Endocrinology and Diabetes Division, 111D, Veterans Affairs Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., Los Angeles, CA 90073, or at gbrent@ucla.edu.

This article has been cited by other articles:

• Hemminki, K., Shu, X., Li, X., Ji, J., Sundquist, K., Sundquist, J. (2009). Familial risks for hospitalized Graves' disease and goiter. Eur J Endocrinol 161: 623-629 [Abstract] [Full Text]  
• Kuy, S., Roman, S. A., Desai, R., Sosa, J. A. (2009). Outcomes Following Thyroid and Parathyroid Surgery in Pregnant Women. Arch Surg 144: 399-406 [Abstract] [Full Text]  
• Bartalena, L., Tanda, M. L. (2009). Graves' Ophthalmopathy. NEJM 360: 994-1001 [Full Text]  
• Rotondi, M., Cappelli, C., Pirali, B., Pirola, I., Magri, F., Fonte, R., Castellano, M., Rosei, E. A., Chiovato, L. (2008). The Effect of Pregnancy on Subsequent Relapse from Graves' Disease after a Successful Course of Antithyroid Drug Therapy. J. Clin. Endocrinol. Metab. 93: 3985-3988 [Abstract] [Full Text]  
• Walter, M. A., Christ-Crain, M., Muller, B., Rotondi, M., Fonte, R., Chiovato, L., Levy, B. S., Metso, S., Jaatinen, P., Salmi, J., Brent, G. A. (2008). Graves' disease.. NEJM 359: 1407-1408 [Full Text]