Graves' disease shares many immunological features with autoimmune thyroiditis and indeed autoimmune hypothyroidism often supervenes years after successful treatment with antithyroid drugs.
It is the production of TSH-R stimulating antibodies which characterizes Graves' disease; these cause sustained hyperthyroidism and the characteristic firm, diffuse goiter found in most patients. Graves' disease is the commonest cause of hyperthyroidism, accounting for 60-80% of cases.
In Europe, the prevalence is around 1% in women aged 35-60 years, with a 5- to 10-fold lower frequency in men. Over 90% of patients with Graves' disease have thyroid-associated ophthalmopathy. Clinically obvious disease is apparent in around 50% of patients, causing lid lag and retraction, nerve compression, with diminishing frequencies: severe congestive pththalmopathy affects less than 5% of patients.