<prompt> Diffuse toxic goiter is characterize by-Primary thyroid diseaseSecondary thyroid diseaseIt is due to autoimmune thyrid hornoneTSH antibodyIt is dne to TSH receptor  <response>: Graves disease, also known as toxic diffuse goiter, is an autoimmune disease that affects the thyroid.Other symptoms may include thickening of the skin on the shins, known as pretibial myxedema, and eye bulging, a condition caused by Graves ophthalmopathy . Graves disease is a primary thyroid disease Ref - davidson 23e p635-640 