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Thyroid orbitopathy

Sajad Moshkelgosha, Giulia Masetti, Utta Berchner-Pfannschmidt, Hedda Luise Verhasselt, Mareike Horstmann, Salvador Diaz-Cano, Alistair Noble, Barbel Edelman, Danila Covelli, Sue Plummer, Julian R Marchesi, Marian Ludgate, Filippo Biscarini, Anja Eckstein, J Paul Banga
Experimental models of hyperthyroid Graves' disease (GD) and Graves' orbitopathy (GO) are efficiently developed by genetic immunisation by electroporation with human thyrotropin hormone receptor (hTSHR) A-subunit plasmid in female BALB/c (H-2d) mice. We investigated susceptibility in C57BL/6 J (H-2b) animals to allow studies on disease mechanisms in transgenic and immune response gene knock-out mice. Higher numbers of female C57BL/6 J were positive for pathogenic thyroid stimulating antibodies, but induced hyperthyroidism remained at a low frequency compared to BALB/c animals...
August 14, 2018: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
Alina Dietrich, Peter Taylor, Paul White, Victoria Wilson, Jimmy Uddin, Richard William John Lee, Colin Dayan, Sue Jackson
Thyroid eye disease (TED) is a potentially sight-threatening and cosmetically disfiguring condition arising in 25-50% of patients with Graves' hyperthyroidism. CIRTED is the first study to evaluate the long-term role of radiotherapy and prolonged immunosuppression with azathioprine in treating TED, one aim of which was to validate the use of the English version of GO-QOL in an UK population with TED. In a three stage design over a 48 week period, the GO-QOL was tested and compared to a general measure of quality of life (WHOQOL-Bref)...
August 9, 2018: Psychology, Health & Medicine
Beata Charążka, Agnieszka Suligowska, Jan Komorowski, Agnieszka Siejka
Thyroid-associated orbitopathy is a syndrome of eye symptoms produced by immunological inflammation of soft tissues of orbit,mostly due to Graves-Basedow disease. This disease is accompanied by proptosis, oedema of lids, double vision, tearing and photophobia. These symptoms lead to significant deterioration of quality of life due to reduction of sharpness of sight and therefore worsen emotional condition of patients. AIM: The aim of study was to assess the impact of Graves orbitopathy on quality of life...
June 27, 2018: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Linda R Dagi
Achieving a successful surgical outcome for patients with vertical misalignment associated with thyroid eye disease remains a challenge, even for the experienced strabismus surgeon. Although tendon-sparing enlargement of the medial rectus and inferior rectus muscles with associated hypotropia and esotropia may be the classic manifestation of extraocular muscle involvement secondary to Graves' orbitopathy,1 neuroimaging2 and forced duction testing often confirm simultaneous involvement of additional extraocular muscles...
July 26, 2018: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Christopher Lo, Shoaib Ugradar, Daniel Rootman
Orbital imaging plays a central role in the diagnosis and management of thyroid-related orbitopathy (TRO). Diagnostically, it is used to compliment a careful ophthalmic examination, laboratory values, and ancillary studies to confirm the presence of TRO and/or dysthyroid optic neuropathy (DON). It can also be helpful in surgical planning and understanding the progression of thyroid myopathy. Computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and nuclear medicine all have applications in the field...
July 25, 2018: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Jan Schovanek, Lubica Cibickova, Marta Karhanova, Dagmar Kovarova, Zdenek Frysak, David Karasek
OBJECTIVE: Graves orbitopathy (GO) is an extrathyroidal manifestation of autoimmune thyroid disease. Early treatment with glucocorticoids in appropriately selected patients is recommended for active, moderate to severe, and sight-threatening disease. The recently published European Group on Graves Orbitopathy guidelines re-evaluated the recommended doses of intravenous methylprednisolone (ivMP) in response to the potential for adverse effects. We retrospectively reviewed our patient cohort treated with our ivMP protocol and analyzed the side effects of this treatment when given during hospitalization in our tertiary referral center...
July 2018: Endocrine Practice
Marie Takeishi, Toshiyuki Oshitari, Satomi Ota, Takayuki Baba, Shuichi Yamamoto
A 76-year-old woman was diagnosed with thyroid-associated orbitopathy (TAO) associated with hypothyroidism at another clinic. Magnetic resonance imaging showed enlargements of the extraocular muscles. Because her best-corrected visual acuity (BCVA) was 0.01OD, she was referred to the Chiba University Hospital. She had an elevation of serum IgG4. She was diagnosed with possible IgG4-related ophthalmic disease (IgG4-ROD) accompanied by optic nerve compression with the mass. She underwent methylprednisolone pulse therapy, and, two months later, her BCVA and visual field defect were greatly improved...
August 2018: Neuro-ophthalmology
Anke Schlüter, Anja K Eckstein, Alexandra Brenzel, Mareike Horstmann, Stephan Lang, Utta Berchner-Pfannschmidt, J Paul Banga, Salvador Diaz-Cano
Objectives: Experimental models of Graves hyperthyroid disease accompanied by Graves orbitopathy (GO) can be efficiently induced in susceptible inbred strains of mice by immunization by electroporation of heterologous human TSH receptor (TSHR) A-subunit plasmid. The interrelated pathological findings in the thyroid glands of Graves disease (GD) that explain the core changes classically include diffuse follicular hyperplasia and multifocal mild lymphocytic infiltrate. However, the relative contributions of different thyroid tissue components (colloid, follicular cells, and stroma) have not been previously evaluated...
June 2018: European Thyroid Journal
Edina Kishazi, Marianne Dor, Simone Eperon, Aurélie Oberic, Natacha Turck, Mehrad Hamedani
The aim was to investigate the levels of cytokines and soluble IL-6R in the tears of patients with thyroid-associated orbitopathy (TAO) disease. Schirmer's test was adopted to collect tears from TAO patients (N = 20, 17 women, mean age (±SD): 46.0 years (±13.4)) and healthy subjects (N = 18, 10 women, 45.4 years (±18.7)). Lacrimal cytokines and soluble IL-6R (sIL-6R) were measured using a 10-plex panel (Meso Scale Discovery Company) and Invitrogen Human sIL-6R Elisa kit, respectively. Tear levels of IL-10, IL-12p70, IL-13, IL-6 and TNF-α appeared significantly higher in TAO patients than in healthy subjects...
July 17, 2018: Scientific Reports
Mehryar Ray Taban
Purpose: Orbital decompression and lower eyelid retraction surgery are traditionally performed separately in staged fashion, which may be unnecessary. Herein, we evaluate the safety and efficacy of combined orbital decompression and lower eyelid retraction surgery. Methods: Retrospective analysis of patients undergoing combined orbital decompression and lower eyelid retraction surgery in patients with or without Graves orbitopathy, by one surgeon from 2016 to 2017...
June 2018: Journal of Current Ophthalmology
Domenico Meringolo, Irene Campi, Giuseppe Costante
No abstract text is available yet for this article.
July 9, 2018: Endocrine
J Zhao, B Lin, H Deng, X Zhi, Y Li, Y Liu, P W Bible, Q Li, B Xu, L Wei, H Yang, D Huang
PURPOSE: Thyroid-associated Ophthalmopathy (TAO) is one of the most common orbital immunological diseases in adults. CD4+ helper T (Th) cells play important roles in the pathogenesis of TAO. But the mechanisms regulating CD4+ T cell activity is unclear. This study examines T cell immunoglobulin domain and mucin domain 3 (TIM-3) expression in helper T cell type 1 (Th1), Th17, and regulatory T cells in sufferers of TAO. METHODS: Participants were divided into 3 groups: patients with TAO, patients with Graves' disease but without orbitopathy (GD), and healthy control patients (HC)...
July 4, 2018: Current Molecular Medicine
Peter J Dolman
PURPOSE: Thyroid eye disease (TED) is an autoimmune disorder causing inflammation, expansion, and fibrosis of orbital fat, muscle, and lacrimal gland. This article reviews the different methods of grading severity and activity of TED and focuses on the VISA Classification for disease evaluation and planning management. METHODS: Accurate evaluation of the clinical features of TED is essential for early diagnosis, identification of high-risk disease, planning medical and surgical intervention, and assessing response to therapy...
July 2018: Ophthalmic Plastic and Reconstructive Surgery
Fotini Adamidou, Panagiotis Anagnostis, Kostas Boboridis, Christina Manani, Thomas Georgiou, Stavroula Veneti, Marina Kita
Intravenous (i.v.) glucocorticosteroids (GCs) constitute the first-line treatment for active and moderate-to-severe Graves' orbitopathy (GO). In cases of persistent disease, rituximab, a monoclonal anti-CD20 antibody, may be used, although studies have yielded conflicting results. In case 1, a 50-year-old female heavy smoker presented with severe bilateral disfiguring eyelid edema of four months, bilateral exophthalmos and a clinical activity score (CAS) of 5/7. Laboratory investigation showed thyrotoxicosis and high thyroid-stimulating immunoglobulin (TSI) levels [32 IU/L (normal <1...
June 22, 2018: Endocrine Journal
Michele Marinò, Francesca Menconi, Giovanna Rotondo Dottore, Marenza Leo, Claudio Marcocci
PURPOSE: To review the in vitro and in vivo studies supporting a role of selenium for the treatment of mild Graves orbitopathy. METHODS: Review of the current literature on the role of selenium in the management of Graves orbitopathy. RESULTS: Graves orbitopathy (GO) is a disfiguring and disabling disorder usually observed in patients with Graves hyperthyroidism, and more rarely in patients with hypothyroid autoimmune thyroiditis or in the absence of overt thyroid dysfunction...
July 2018: Ophthalmic Plastic and Reconstructive Surgery
G Lanzolla, E Sabini, M A Profilo, B Mazzi, A Sframeli, R Rocchi, F Menconi, M Leo, M Nardi, P Vitti, C Marcocci, M Marinò
BACKGROUND: It has been suggested that high cholesterol represents a risk factor for Graves' orbitopathy (GO). In a recent cross-sectional study, a correlation between cholesterol and the presence of GO was found in patients with a Graves' disease (GD) of recent onset. To confirm this observation, we conducted a retrospective investigation in consecutive patients with GD. The primary outcome was the relationship between the presence of GO and low-density lipoprotein (LDL)-cholesterol...
June 19, 2018: Journal of Endocrinological Investigation
Anja Eckstein, Joachim Esser, Michael Oeverhaus, Peerooz Saeed, Hinke Marijke Jellema
PURPOSE: To review the authors' current understanding of motility dysfunction in patients with thyroid eye disease and to summarize appropriate evaluation and available management options. METHODS: Data were retrieved from a systematic search of the literature. RESULTS: Diplopia is one of the most disabling symptoms for Graves orbitopathy patients. It occurs in moderate-to-severe Graves orbitopathy stages and does not respond well to available anti-inflammatory treatment...
July 2018: Ophthalmic Plastic and Reconstructive Surgery
Sathyadeepak Ramesh, Alexander Nobori, Yi Wang, Daniel Rootman, Robert Alan Goldberg
PURPOSE: To test the hypothesis that the orbit expands in the cranial vault after wide dural exposure after minimally invasive extradural transorbital decompression for thyroid eye disease. METHODS: A cross-sectional cohort study of 36 patients (60 orbits). Preoperative and postoperative (6 months) orbital CT following extradural transorbital decompression was analyzed. Primary outcome measure was the percentage area of the cranial vault occupied by orbital and brain tissue in a predefined window before and after surgery...
June 6, 2018: Ophthalmic Plastic and Reconstructive Surgery
Ana Valea, Carmen Emanuela Georgescu
Selenium (Se) has a multilevel, complex and dynamic effect on the human body as a major component of selenocysteine, incorporated into selenoproteins, which include the selenocysteine-containing enzymes iodothyronine deiodinases. At the thyroid level, these proteins play an essential role in antioxidant protection and hormone metabolism. This is a narrative review based on PubMed/Medline database research regarding thyroid physiology and conditions with Se and Se-protein interferences. In humans, Se-dependent enzyme functions are best expressed through optimal Se intake, although there is gap in our knowledge concerning the precise mechanisms underlying the interrelation...
June 5, 2018: Hormones: International Journal of Endocrinology and Metabolism
Panagiotis Anagnostis, Aikaterini Artzouchaltzi, Alexandra Grekou, Stavroula A Paschou, Spyridon Gerou, Vasilios Tzalokostas
Pretibial myxedema (PM) is a rare extrathyroidal manifestation of Graves' disease (GD), usually during the hyperthyroid state, coexisting with orbitopathy. We describe a rare case of a biopsy-proven PM in a euthyroid patient, without history of GD or Hashimoto's thyroiditis. Assessment of commonly reported thyroid autoantibodies, such as thyroid peroxidase and thyroglobulin autoantibodies, thyroid stimulating immunoglobulins and thyroid binding inhibitory immunoglobulins, was negative. Resolution of skin pathology was achieved after topical application of corticosteroids and was sustained 1 year later...
March 2018: Hormones: International Journal of Endocrinology and Metabolism
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