The rebel thyroid of a revolutionary First Lady.

Nadezda Krupskaya, the revolutionary Russian and Lenin's wife, was affected by Graves' disease and many photos and portraits, including the painting of 1933 by Ivan Vladimirovich Kosmin, highlight evident goiter and exoftalmos. To treat Graves' disease, Krupskaya underwent to surgery performed by Theodor Kocher, considered the father of the modern thyroid surgery.

The philosopher Socrates had exophthalmos (a term coined by Plato) and probably Graves' disease.

According to a previously published theory, Socrates was afflicted with temporal lobe epilepsy since his childhood. Plato, Xenophon, and Aristoxenus described Socrates as having exophthalmos, probably diplopia, and some symptoms compatible with hyperthyroidism. Using these data, we theorize that Socrates had Graves' disease. In order to determine a cause of his temporal lobe epilepsy, we speculate that the philosopher also had autoimmune thyroiditis and Hashimoto encephalopathy during his childhood and his epilepsy may have been a sequel to this hypothesized encephalopathy.

Prevalence and natural history of Graves' orbitopathy in the XXI century.

Graves' orbitopathy (GO) is an autoimmune disorder and the main extrathyroidal expression of Graves' disease. There is a spectrum of ocular involvement in Graves' disease, from complete absence of symptoms and signs to sight-threatening conditions. The prevalence of GO varies in different published series of Graves' patients, due to confounding factors (new diagnosis vs long-lasting disease, way of defining and assessing ocular involvement, treatment of hyperthyroidism with potentially GO-modifying treatments, such as radioiodine). Recent studies, however, suggest that most Graves' patients have mild or no GO at presentation, while moderate-to-severe GO is rare, and sight-threatening GO (mostly due to dysthyroid optic neuropathy) is exceptional in non-tertiary referral centers. The natural course of GO is incompletely defined, particularly in patients with moderate- to-severe GO, because these patients require prompt and disease-modifying therapies for orbital disease. In patients with mild GO at presentation, progression to severe forms is rare, while partial or complete remission is frequent. Progression of pre-existing GO or de novo occurrence of GO is more likely in smokers. There seems to be a trend towards a decline in progression of GO, possibly due to a better control of risk factors (cigarette smoking, thyroid dysfunction, etc.) and a closer interaction between endocrinologists and ophthalmologists allowing an improved integrated management of thyroid and orbital disease.

Maximinus Daia, a Roman emperor who may have had Graves' disease and died of a thyrotoxic crisis.

Evidence is presented that the Roman emperor Maximinus Daia had Graves' disease and died of severe thyrotoxicosis. The information about this emperor's terminal illness is drawn from the writings of the 4th century writers Eusebius and Lactantius. An existing statue indicates that the emperor had bilateral Graves' ophthalmopathy.

A tale of two celts.

The eponym "Graves' disease" is usually applied to the condition of immunogenic hyperthyroidism, in no small part due to the promotion and influence of the French physician Armand Trousseau who wrote in 1862, "Du Goître Exophthalmique, ou Maladie de Graves." However, the distinguished Bath physician Caleb Hillier Parry, a friend of both Edward Jenner and John Hunter, first described the clinical picture of thyrotoxicosis associated with exophthalmos and cardiac dysfunction in a paper published posthumously in 1825, some 10 years before Robert Graves' initial report. Graves was unaware of Parry's earlier description and considered that the thyroid condition in the four female cases that he studied might be secondary to functional cardiac disorders and palpitations. The many outstanding contributions to medicine and science of Parry and Graves, two truly remarkable nineteenth century Celtic physicians, are compared and discussed. A case is made for considering the renaming of immunogenic hyperthyroidism as Parry's disease, a proposal made by Sir William Osler, who was the first to recognise Parry's claim for priority for the recognition of exophthalmic goitre.

Avicenna, the first to describe thyroid-related orbitopathy.

The history of the association of goiter and orbital disease is discussed. Although Graves and Basedow are credited with the first descriptions of this association, it was described many years earlier between AD 1000 and 1110 by two Persian physicians and philosophers, Avicenna and Al-Jurjani.

La enfermedad de Graves, signos y síntomas / Graves' disease, sign and symptoms

La enfermedad de Graves es la causa más común de hipertiroidismo, es de patogenia autoinmune. Se distingue clínicamente de otras formas de hipertiroidismo por la presencia de bocio difuso, oftalmopatía y ocasionalmente mixedema pretibial. En este artículo describimos la vida y obra de Robert Graves, realizando posteriormente una revisión de los signos y síntomas de la enfermedad. En el mundo de la medicina actual, en donde la tecnología juega un rol preponderante, queremos recordar la importancia de la anamnesis y el examen físico como herramienta indispensable del clínico

Graves’disease is by far the most common cause of hyperthyroidism. Is an immunologic disorder and it is distinguished clinically from other forms of hyperthyroidism by the presence of diffuse thyroid enlargement, ophthalmopathy, and occasionally pretibial myxedema. In this paper we summarize the prolific life of Robert Graves and we also describe the signs and symptoms of hyperthyroidism. In today’s medicine, were technology plays a very important role, we would like to remark the value of anamnesis and physical exam as some of the most useful tools

[The history of thymus surgery]. / Die Geschichte der Thymuschirurgie.

Thymus surgery was initially dominated by the erroneous interpretation of the organs' pathogenicity and associated thymus diseases. Misleadingly, the thymus gland was made responsible for dyspnoea in children and a transcervical ektropexia was performed in a child suffering from dyspnoea in 1896. After F. Sauerbruch's thymectomy in a patient with myasthenia gravis syndrome (MG), A. Blalock established thymectomy in the 1940s for the treatment of MG. At the same time, the drug treatment initiated by M.B. Walker increased in significance. Despite progress in surgical techniques and the molecular understanding of MG pathogenesis, randomized controlled trials, which would increase the evidence for surgical access and indications for surgery compared to immunosuppressive treatment in MG, are lacking.

[Graves disease, sign and symptoms]. / La enfermedad de Graves, signos y síntomas.

Graves disease is by far the most common cause of hyperthyroidism. Is an immunologic disorder and it is distinguished clinically from other forms of hyperthyroidism by the presence of diffuse thyroid enlargement, ophthalmopathy, and occasionally pretibial myxedema. In this paper we summarize the prolific life of Robert Graves and we also describe the signs and symptoms of hyperthyroidism. In today s medicine, were technology plays a very important role, we would like to remark the value of anamnesis and physical exam as some of the most useful tools.