**1. Introduction**

Graves' Disease (GD) is the most common cause of hyperthyroidism worldwide [1, 2]. It was first described by German physician Carl Adolf Von Basdow. It is an autoimmune disorder characterized by presence of TSH receptor autoantibody [3]. These autoantibodies stimulate TSH receptors on thyroid cells and cause hypertrophy and hyperplasia resulting thyroid gland enlargement. TSHR autoantibodies also cause increased synthesis and secretion of thyroid hormones. GD is primarily disease of thyroid gland but affects multi organ system i.e. heart, liver, muscle, eye and skin. Graves' ophthalmopathy and pretibial myxedema are extrathyroidal manifestations of GD which results from action of TSHR autoantibodies on TSHR present onfibroblast, adipocyte and T cells in extrathyroidal tissue.
