Most common. Graves’ disease is an organ-specific autoimmune disease with a background of genetic susceptibility, infection, trauma and other factors that induce immune dysfunction in the body, resulting in a weakening of the inhibitory effect of Ts cells on T lymphocytes and the production of heterogeneous immunoglobulins (autoantibodies) by specific B lymphocytes, which are closely related to thyroid excitatory autoantibodies. Increased synthesis and secretion of T3 and T4 leads to clinical manifestations of Graves’ disease: 1) thyrotoxicosis 2) diffuse goiter 3) Graves’ ophthalmopathy 4) anterior tibial mucinous edema Clinical manifestations (a) thyrotoxicosis manifestations (excessive secretion of thyroid hormones) 1) hypermetabolic symptoms: increased heat production and heat dissipation, manifested as: fear of heat, excessive sweating, palpitations, hyperactivity 2) neuropsychiatric excitement Expression: excitement, anxiety, talkative, dryness, hyperactive tendon reflexes, muscle tremors 3, cardiovascular system: palpitations, chest tightness, shortness of breath, resting heart rate >90 beats/min, arrhythmia, heart enlargement, increased pulse pressure difference. 4, digestive system: increased gastrointestinal motility; easy hunger and overeating, indigestion, hyperthyroid liver disease, etc. 5, musculoskeletal system: periodic paralysis, acute and chronic hyperthyroid myopathy, osteoporosis 6, reproductive system: scanty menstruation, amenorrhea, impotence. 7, hematopoietic system: mild anemia, lymphocytes, monocytes ↑, leukocytes clinical signs thyroid enlargement diffuse, symmetrical enlargement, soft (tough), moving up and down with swallowing movements, also asymmetrical or lobulated, tremors can be felt in the right and left upper and lower poles, vascular murmurs can be heard. There is no significant relationship between the degree of enlargement and the severity of hyperthyroidism. Very rarely, the thyroid gland is located in the retrosternal mediastinum. Grade I enlargement: invisible, palpable Grade II enlargement: visible, palpable, not beyond the sternocleidomastoid muscle Grade III enlargement: beyond the sternocleidomastoid muscle Eye signs: About 25-50% of GD patients have eye signs, of which proptosis is one of the important and specific signs. 1. Benign proptosis (non-invasive proptosis): ①Proptosis <18mm, upper eyelid contracture, widening of the eye fissure, and the upper edge of the cornea is exposed when looking flat. (2) The gaze is bright, with few transient eyes. ③Upward looking forehead cannot be wrinkled. ④Both eyes have poor convergence. ⑤ When looking down, the upper eyelid cannot fall with the eyeball.