TSHR gene mutations are one of the causes of non-autoimmune hyperthyroidism (6, 7), and neonatal non-autoimmune hyperthyroidism is associated with the TSHR gene c.1856A>G (p.Asp619Gly) heterozygous mutation (8); (2) the cytotoxic T-lymphocyte associated protein 4 (CTLA4) gene. Here, CTLA4 is linked to Graves disease.