It is the production of TSH-R stimulating antibodies which characterizes Graves' disease; these cause sustained hyperthyroidism and the characteristic firm, diffuse goiter found in most patients. Graves' disease is the common cause of hyperthyroidism, accounting for 60-80% of cases.
In Europe, the prevalence is around 1 % in women aged 35-60 years, with a 5 to 10-times lower frequency in men. Over 90 % of patients with Graves' disease have thyroid-associated ophthalmopathy. Clinically obvious disease is apparent in around 50 % of patients, causing lid lag and retraction, nerve compression, with diminishing frequencies: severe congestive ophthalmopathy affects less than 5 % of patients.