Graves

B-cell & Limfosit T

Trioglobulin, peroksidase tiroid, sodium iodida symporter, throtropin receptor

Thyroid Stimulating Globulin

Throtropin receptor

Activate throtropin receptor

High T4 & T3 T-cell produce

inflammatory

Cytokinase

Low thyrotropin

Increase glycosamino

Release tiroid &trioglobulin homone glycans

antiorbital muscle

Antibody

3, 5 cyclic adenosine monophosphate

Retro-orbital fibroblast

Iodine uptake, protein shyntesis,

Thyroid gland growth ophtalomopath

Hipertiroidism

Hipertiroidisme

Hipersekresi hormone tiroid

TSH menurun

T3 & T4

Metabolisme tubuh Hiperaktivitas SSP

Gemetar, lelah, keringat bnyk aktifitas GI nafsu

makan

Intoleransi aktivitas diare, produksi urine BB

Atrofi ott dehidrasi gg. nutrsi

Elektrolit imbalance
 Hipertiroidisme

T3 masuk nucleus

DNA response elementary

Gen mengkode protein structural & protein regulator

Mengubah konsentrasi kalsium dan kalium

Inotropik dan kronotropik meningkat

Electricsl remodelling

aritmia
In Graves disease, B and T lymphocyte-mediated autoimmunity are known to be
directed at 4 well-known thyroid antigens: thyroglobulin, thyroid peroxidase,
sodium-iodide symporter, and the thyrotropin receptor. However, the thyrotropin
receptor itself is the primary autoantigen of Graves disease and is responsible for
the manifestation of hyperthyroidism. In this disease, the antibody and cell-
mediated thyroid antigen-specific immune responses are well defined. Direct
proof of an autoimmune disorder that is mediated by autoantibodies is the
development of hyperthyroidism in healthy subjects by transferring thyrotropin
receptor antibodies in serum from patients with Graves disease and the passive
transfer of thyrotropin receptor antibodies to the fetus in pregnant women.

The thyroid gland is under continuous stimulation by circulating autoantibodies

against the thyrotropin receptor, and pituitary thyrotropin secretion is
suppressed because of the increased production of thyroid hormones. The
stimulating activity of thyrotropin receptor antibodies is found mostly in the
immunoglobulin G1 subclass. These thyroid-stimulating antibodies cause release
of thyroid hormone and thyroglobulin that is mediated by 3,'5'-cyclic adenosine
monophosphate (cyclic AMP), and they also stimulate iodine uptake, protein
synthesis, and thyroid gland growth.

(Medscape)