Acropachy, thyroid

C. Thyroid clubbing (acropachy). (Reprinted, with permission, from Jameson JL, Weetman AP. Disorders of the thyroid gland. In Kasper DL, Braunwald E, Fauci AS, et al, (eds.) Harrison s Principles of Internal Medicine. 16th edition. New York McGraw-Hill 2004 2114.)... 

Hyperthyroidism results in a hypermetabolic state due to an excess of thyroid hormones. Hyperthyroidism is more common in women (2%) than men (0.1%). Graves disease is an autoimmune disorder that leads to hyperthyroidism, diffuse goiter, ophthalmopathy, dermopathy, and acropachy. Graves disease is the most common cause of hyperthyroidism, more common than multi- or uninodular goiters. 

Graves disease " is an autoimmune syndrome that may include hyperthyroidism, diffuse thyroid enlargement, exophthalmos, pretibial myxedema, and thyroid acropachy (Figs. 73 and 73-5). Graves disease is the most common cause of hyperthyroidism. The prevalence of Graves disease is estimated to be 3 per... 

The thyroid gland is diffusely enlarged in the majority of patients and is commonly 40 to 60 g (two to three times the normal size). The surface of the gland is smooth and the consistency varies from soft to firm. In patients with severe disease, a thriU may be felt and a systolic bruit may be heard over the gland. The presence of any of the extrathyroidal manifestations of this syndrome including exophthalmos, thyroid acropachy, or pretibial myxedema in a thyrotoxic patient is pathognomonic of Graves disease (see Fig. 73-4). 

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