Epidemiology

In iodine-sufficient parts of the world, the prevalence of overt hyperthyroidism is 0.2% to 1.3%.[11] Graves disease is the most common form of hyperthyroidism in most areas of the world, including the US.[12][13][14] In areas of iodine deficiency and endemic goiter, particularly in the older age group, toxic multinodular goiter is more common.[11][13]

The incidence of Graves disease is between 20-50 cases per 100,000 person per year.[2]​​[15]​  Graves disease is around 6 times more common in women than in men and individuals of any age can be affected, with incidence peaking between 30 and 50 years of age.[2]​ Subclinical hyperthyroidism due to Graves disease is seen in around 6% of all patients with subclinical hyperthyroidism.[15][16]​ 

One study reported higher incidence rates of Graves disease among black and Asian/Pacific Islander active-duty US military personnel compared with their white counterparts.[17]​ 

Among patients with Graves disease, around 25% have clinical orbitopathy.[1] However, the frequency of subtle, subclinical Graves orbitopathy may be higher.[12] Among patients with orbitopathy, 4% to 12% have pretibial myxedema.​[10][18][19]​​ The incidence and severity of Graves orbitopathy in Europe has declined over the past decade.[20][Figure caption and citation for the preceding image starts]: Lid retraction, mild proptosis, and mild chemosisCourtesy of Dr Vahab Fatourechi [Citation ends].com.bmj.content.model.Caption@1b51d752[Figure caption and citation for the preceding image starts]: Pretibial myxedema (nonpitting edema)Courtesy of Dr Vahab Fatourechi [Citation ends].com.bmj.content.model.Caption@b9e6f34

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