Which finding is most commonly associated with Graves disease?

• A. Heat intolerance
• B. Fatigue
• C. Exophthalmos
• D. Weight gain

Answer: (C)

Graves disease is an autoimmune thyroid condition that often causes excess thyroid hormone and eye involvement. The most distinctive and commonly associated finding is exophthalmos. Antibodies against the TSH receptor stimulate not only the thyroid but also tissues behind the eyes. In the orbit, these antibodies activate fibroblasts, leading to inflammation, edema, and accumulation of substances like glycosaminoglycans. This causes the eye area to swell and the eyes to protrude, sometimes with lid retraction and double vision. While heat intolerance and weight loss are common hyperthyroidism symptoms, they’re not specific to Graves. Exophthalmos is the feature most characteristically linked to Graves disease.