**3.2 Graves' disease**

Graves' disease is an autoimmune disorder caused by anti-TSH receptor antibody. These antibodies interact with TSH receptor and cause increased thyroid hormone synthesis and secretion [17]. Many risk factors have been found in causation of Graves' disease including high iodine intake and stress [18, 19]. Several drugs have also been implicated in etiology of Graves' disease including lithium,

interferon α, and alemtuzumab [20–22]. Other autoimmune manifestations associated with Graves' disease are pretibial myxedema and ophthalmopathy. Graves' disease is the most common cause of thyrotoxicosis [23]. It is more common in females and usually presents before 30 years of age. Graves' disease presents with classical symptoms of thyrotoxicosis, i.e., irritability, sleeplessness, palpitations, excessive sweating, heat intolerance, and weight loss.
