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Atypical Clinical Manifestations of Graves Disease An Analysis in Depth英文文献资料.doc

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Atypical Clinical Manifestations of Graves Disease An Analysis in Depth英文文献资料

HindawiPublishingCorporation JournalofThyroidResearch Volume2012,ArticleID768019,8pages doi:10.1155/2012/768019 ReviewArticle AtypicalClinicalManifestationsofGraves’Disease: AnAnalysisinDepth MohamedOsamaHegaziandSherifAhmed MedicalDepartment,AlAdanHospital,P.O.Box262,Hadiya52853,Kuwait CorrespondenceshouldbeaddressedtoMohamedOsamaHegazi,drosama02@ Received25June2011;Revised30July2011;Accepted1September2011 AcademicEditor:JuanC.Galofr′e Copyright?2012M.O.HegaziandS.Ahmed.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttribution License,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperly cited. Overthepastfewdecades,therehasbeenanincreaseinthenumberofreportsaboutnewlyrecognized(atypicalorunusual) manifestationsofGraves’disease(GD),thatarerelatedtovariousbodysystems.Oneofthesemanifestationsissometimesthe mainpresentingfeatureofGD.Someoftheatypicalmanifestationsarespeci?callyrelatedtoGD,whileothersarealsosimilarly seeninpatientswithotherformsofhyperthyroidism.Lackofknowledgeoftheassociationbetweenthese?ndingsandGDmay leadtodelayindiagnosis,misdiagnosis,orunnecessaryinvestigations.TheatypicalclinicalpresentationsofGDincludeanemia, vomiting,jaundice,andrightheartfailure.Thereisonetypeofanemiathatisnotexplainedbyanyoftheknownetiologicalfactors andrespondswelltohyperthyroidismtreatment.ThistypeofanemiaresemblesanemiaofchronicdiseaseandmaybetermedGD anemia.OtherformsofanemiathatareassociatedwithGDincludeperniciousanemia,ironde?ciencyanemiaofceliacdisease, andautoimmunehemolyticanemia.VomitinghasbeenreportedasapresentingfeatureofGraves’disease.Somecaseshadthe typical?ndingsofhyperthyroidisminitiallymasked,andthevomitingdidnotimproveuntilhyperthyroidismhasbeendetected andtreated.Hyperthyroidismmaypresentwithjaundice,andontheotherhand,deepjaundicemaydevelopwiththeonsetofovert hyperthyroidisminpreviouslycompensatedchronicliverdiseasepatients.Pulmonaryhypertensionisreportedtobeassociated withGDandtorespondtoitstrea