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Thyroid orbitopathy

Jonathan C P Roos, Carla Moran, V Krishna Chatterjee, Joanne Jones, Alasdair Coles, Rachna Murthy
Alemtuzumab-a monoclonal antibody targeting the CD52 glycoprotein expressed by most mature leucocytes-effectively decreases relapse rate and disability progression in early, relapsing-remitting multiple sclerosis (MS). However, secondary autoimmune disorders complicate therapy in nearly 50% of treated patients, with Graves' disease being the most common. Rarely, thyroid eye disease (TED) ensues; only seven such cases have been reported. Our aim was to analyse the largest series of MS patients developing thyroid eye disease after alemtuzumab treatment...
November 29, 2018: Eye
Ahmet Murat Sarici, Burak Mergen, Velittin Oguz, Cezmi Dogan
BACKGROUND: Previous techniques resulted with low rates of successful fusion after the surgeries and high necessity of additional surgeries in the treatment of thyroid orbitopathy related strabismus. In this study, reviewing the results of our patients who had surgical correction with relaxed muscle positioning technique due to thyroid orbitopathy related strabismus to evaluate the effectiveness of the surgery was aimed. METHODS: The medical records of 8 patients who had surgical correction with intraoperative relaxed muscle positioning (IRMP) technique were studied retrospectively...
November 23, 2018: BMC Ophthalmology
Ji Won Kim, JaeSang Ko, JinJoo Kim, Jin Sook Yoon
PURPOSE: Early detection and control of inflammation are important to manage Graves' orbitopathy (GO). We investigated the effects of calprotectin (S100A8/A9) on orbital fibroblast inflammation and GO pathogenesis. METHODS: We measured serum calprotectin, S100A8 and S100A9 mRNA expression in orbital fat/connective tissue from GO patients and healthy controls, and proinflammatory cytokines in primary cultured orbital fibroblasts. RESULTS: The serum levels of S100A8/A9 and the expression of S100A8/A9 mRNA in orbital tissue were higher in the GO patients than in the healthy controls...
November 19, 2018: Ocular Immunology and Inflammation
Mladen Lešin, Veljko Rogošić, Lucija Vanjaka Rogošić, Igor Barišić, Goran Pelčić
Thyroid-associated orbitopathy (TAO) is a common manifestation of Graves' disease. The aim of the study was to assess the six percent of patients with TAO that develop dysthyroid optic neuropathy (DON), which is the most serious complication of TAO. As DON can cause perma-nent damage, it is essential to detect DON early when visual loss is still reversible. Color Doppler ultrasound is a noninvasive diagnostic method, which may be useful in early detection of DON. Thirty-six patients with confirmed Graves' disease and active TAO were included, 21 (58%) of them with early DON (eDON) and 15 (42%) free from any signs of eDON...
June 2018: Acta Clinica Croatica
Jonathan C P Roos, Vignesh Paulpandian, Rachna Murthy
The Thyrotropin receptor antibody (TRAb) is the main driver of Graves' disease (GD) and its most common extra-thyroidal manifestation: thyroid eye disease (TED). Though key to diagnosis, it has not been used routinely as a marker of disease activity or to guide treatment. Here we demonstrate, through a retrospective review of 105 patients with TED, that serial TRAb levels vary with time, correlate with disease activity and are affected by smoking and endocrine control. Such serial measurements can guide the modern management of thyroid eye disease, helping to prevent the more serious manifestations...
November 6, 2018: Eye
Fumihito Hikage, Stephen Atkins, Alon Kahana, Terry J Smith, Tae-Hwa Chun
Thyroid-associated orbitopathy (TAO) is a disfiguring periocular connective tissue disease associated with autoimmune thyroid disorders. TAO is a potentially blinding eye condition, for which no effective pharmacological treatment has been established. Despite a suggested role played by autoimmune thyrotropin receptor activation in the pathogenesis of TAO, the cellular and molecular events contributing to the fibrotic and inflammatory disease process of TAO is not fully defined. By developing a three-dimensional (3D) organoid culture of human orbital fibroblasts (hOFs), we sought to determine the molecular mechanism underlying fibrotic disease process of TAO...
November 1, 2018: Endocrinology
Talia Diker-Cohen, Hadar Duskin-Bitan, Ilan Shimon, Dania Hirsch, Amit Akirov, Gloria Tsvetov, Eyal Robenshtok
OBJECTIVE: Male gender is considered an adverse prognostic factor for remission of Graves' disease treatment with anti-thyroid drugs (ATD), though published data is conflicting. This often results in early consideration of radioiodine treatment and surgery for men. Our objective was to compare disease presentation and outcome in men versus women treated with ATDs. METHODS: Retrospective study of 235 patients (64 men, 171 women) with Graves' disease who were evaluated for features at presentation and outcome at the end of follow-up between 2010 and 2015...
November 1, 2018: Endocrine Practice
Gerd Krause, Patrick Marcinkowski
The thyrotropin receptor (TSHR), the lutropin- (LHR), and the follicotropin receptor (FSHR) belong to glycoprotein hormone receptors (GPHR), a subgroup of the class A G-protein coupled receptors. In this review, the unique features of GPHR have been taken into account for their pharmacological interventions: i) The respective hormone and stimulating or blocking antibodies are binding on the large ectodomain that is ii) via a hinge region, containing iii) an internal tethered agonist linked to the transmembrane domain...
October 26, 2018: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
Patrick Marcinkowski, Inna Hoyer, Edgar Specker, Jens Furkert, Claudia Rutz, Martin Neuenschwander, Sebastian Sobottka, Han Sun, Marc Nazare, Utta Berchner-Pfannschmidt, Jens Peter von Kries, Anja Eckstein, Ralf Schülein, Gerd Krause
The thyrotropin receptor (TSHR) is the target for autoimmune thyroid stimulating antibodies (TSAb) triggering hyperthyroidism. Whereas elevated thyroid hormone synthesis by the thyroid in Graves' disease (GD) can be treated by anti-thyroid agents, for the pathogenic activation of TSHR in retro-orbital fibroblasts of the eye, leading to Graves' orbitopathy (GO), no causal TSHR directed therapy is available. Due to the therapeutic gap for severe GO, we identified TSHR inhibitors by high-throughput screening in CHO cells expressing the TSHR...
October 23, 2018: Thyroid: Official Journal of the American Thyroid Association
Blandine Tramunt, Philippe Imbert, Solange Grunenwald, Franck Boutault, Philippe Caron
CONTEXT: Sight-threatening Graves' orbitopathy affects 3 to 5% of patients with Graves' orbitopathy. OBJECTIVES: To describe the management of patients with sight-threatening Graves' orbitopathy seen in a multidisciplinary thyroid-eye outpatient clinic dedicated to Graves' orbitopathy (GO). PATIENTS AND METHODS: We enrolled all patients with sight-threatening GO (dysthyroid optic neuropathy and corneal ulcer as defined in the EUGOGO statement) seen and treated in our GO multidisciplinary thyroid-eye outpatient clinic over the last two decades...
October 19, 2018: Clinical Endocrinology
Julie Garon-Czmil, Nadine Petitpain, Franck Rouby, Marion Sassier, Samy Babai, Melissa Yelehe-Okouma, Georges Weryha, Marc Klein, Pierre Gillet
Immunotherapy with immune checkpoint inhibitors (ICIs) for cancer has become increasingly prescribed in recent years. Indeed, it is used to treat both solid and hematological malignancies due to their considerable potential in treating melanoma, non-small cell lung and other cancers. Immune-mediated related adverse endocrine toxicity, and especially thyroiditis, is seen as a growing problem needing specific screening and management. This study aims at describing thyroid dysfunctions induced by the ICIs marketed in France, which are registered in the French Pharmacovigilance database...
October 11, 2018: Fundamental & Clinical Pharmacology
Petros Perros
Significant scientific progress has been achieved in the past decade in thyroidology driven by scholarly enquiry, unmet patient needs, and investment by the pharmaceutical and diagnostics industry. In this review, nine publications have been selected for their impact in pushing the frontiers of knowledge and understanding. They include new perspectives in the diagnosis, pathophysiology, epidemiology and management of thyroid cancer, understanding of thyroid hormone physiology, and new treatments for Graves' orbitopathy...
October 10, 2018: Hormones: International Journal of Endocrinology and Metabolism
Liliana R Santos, Celestino Neves, Miguel Melo, Paula Soares
Selenium is an essential micronutrient that is required for the synthesis of selenocysteine-containing selenoproteins, processing a wide range of health effects. It is known that the thyroid is one of the tissues that contain more selenium. The "selenostasis" maintenance seems to contribute to the prevention of immune mediated thyroid disorders. Prospective, observational studies, randomized, controlled studies evaluating selenium supplementation, and review articles that are available in Medline and PubMed have undergone scrutiny...
October 4, 2018: Diagnostics
George J Kahaly, Luigi Bartalena, Lazlo Hegedüs, Laurence Leenhardt, Kris Poppe, Simon H Pearce
Graves' disease (GD) is a systemic autoimmune disorder characterized by the infiltration of thyroid antigen-specific T cells into thyroid-stimulating hormone receptor (TSH-R)-expressing tissues. Stimulatory autoantibodies (Ab) in GD activate the TSH-R leading to thyroid hyperplasia and unregulated thyroid hormone production and secretion. Diagnosis of GD is straightforward in a patient with biochemically confirmed thyrotoxicosis, positive TSH-R-Ab, a hypervascular and hypoechoic thyroid gland (ultrasound), and associated orbitopathy...
August 2018: European Thyroid Journal
Yun-Gang Ding, Guo Chen, Qian Li, Xiao-Feng Wen, Lai Wei, Hua-Sheng Yang
AIM: To investigate the association between IL-10-producing regulatory B (B10) cells and the clinical features of thyroid-associated orbitopathy (TAO). METHODS: A total of 30 patients with TAO were recruited at Zhongshan Ophthalmic Center from May 2015 to December 2015. Peripheral blood mononuclear cells (PBMCs) were separated from blood samples of 30 TAO patients and 16 healthy controls and stimulated with CD40 ligand and CpG for 48h. The frequency of IL-10+ B cells was examined by flow cytometry and the correlation between the frequency of IL-10+ B cells and clinical features of TAO was analyzed by SPSS...
2018: International Journal of Ophthalmology
T Pichard, A Paillard, M Santallier, L Criniere, P Pierre, P-J Pisella, B Laure, S Arsene
INTRODUCTION: Thyroid-related immune orbitopathy often results in a restrictive strabismus. We report our experience of surgical management in these cases. PATIENTS AND METHODS: We present a retrospective case series conducted on 32 patients, operated between 2008 and 2017. Strabismus surgery was proposed in the postinflammatory stage with stable clinical findings for at least 6 months. It was performed under general anesthesia by recessions of restrictive muscles using a fixed suture technique...
October 2018: Journal Français D'ophtalmologie
J Ruiz-Medrano, D Díaz-Valle, R Cuiña, J A Gegúndez, J Chhablani, P D Majumder, R Gutierrez-Bonet
PURPOSE: With uveitis being one of the leading causes of blindness worldwide, biological therapies have arisen as an option for the treatment of refractory cases based on good results shown in clinical practice. The goal of this study is to provide a systematic review of current knowledge of the role and possible uses of tocilizumab in the field of ophthalmology. MATERIALS AND METHODS: We performed a search for records reporting the use of tocilizumab for various diseases in MEDLINE (PubMed and OVID)...
October 2018: Journal Français D'ophtalmologie
Sopio Tatulashvili, Camille Baudry, Jean Louis Sadoul, Hélène Bihan
Graves' thyroiditis is a frequent disease. It has a considerable impact on patient's life quality and health expenses. Thus, it is important to optimize the treatment and follow up. The identification of new factors predisposing to the disease and factors that may help to predict the severity or recurrence of the disease or the occurrence of graves' orbitopathy could optimize the management. Genetic predisposition has a major role in the development of Graves' disease. The new genes in addition to those already known to be involved in Graves' disease are under study...
September 2018: Annales D'endocrinologie
Bernard Corvilain, Antoine Hamy, Laurent Brunaud, Françoise Borson-Chazot, Jacques Orgiazzi, Leila Bensalem Hachmi, Mourad Semrouni, Patrice Rodien, Charlotte Lepeutre
Treatment strategy in Graves' disease firstly requires recovery of euthyroid status by antithyroid therapy. Treatment modalities, precautions, advantages and side-effects are to be discussed with the patient. No particular treatment modality has demonstrated superiority. Pregnancy or pregnancy project affects choice of treatment and monitoring. Graves' orbitopathy is liable to be aggravated by iodine-131 treatment and requires pre-treatment assessment. Iodine-131 treatment aims at achieving hypothyroidism. Thyroid surgery for Graves' disease should preferably be performed by an expert team...
August 16, 2018: Annales D'endocrinologie
Christina N Kraus, Pooja Sodha, Priya Vaidyanathan, A Yasmine Kirkorian
The extrathyroid manifestations of Graves disease (GD) include thyroid orbitopathy, dermopathy, and acropachy. Thyroid dermopathy (TD), also known as pretibial myxedema, classically presents as nonpitting edema or plaquelike lesions on the pretibial region, while thyroid acropachy (TA) is seen in cases of severe TD, characterized by soft tissue swelling and clubbing of fingers and toes, as well as a periosteal reaction of the bones of the hands and feet. Both TD and TA are rare manifestations of thyroid disease and uncommonly reported in pediatric patients...
November 2018: Pediatric Dermatology
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