Clinical features

Raised levels of circulating thyroid hormone have predictable clinical effects depending on the organ system and are similar to the symptoms and signs of catecholamine excess (see Table 10.3.1). The onset of symptoms in Graves’ disease is usually insidious and variable in severity between patients. Severe ophthalmopathy or dermopathy is rare in children. Most patients with Grave’s disease will have a goitre characterized by diffuse, non-tender and symmetrical enlargement of the thyroid gland.