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Graves ophthalmopathy

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https://www.readbyqxmd.com/read/28713331/thyroid-stimulating-hormone-receptor-antibodies-in-pregnancy-clinical-relevance
#1
REVIEW
Ines Bucci, Cesidio Giuliani, Giorgio Napolitano
Graves' disease is the most common cause of thyrotoxicosis in women of childbearing age. Approximately 1% of pregnant women been treated before, or are being treated during pregnancy for Graves' hyperthyroidism. In pregnancy, as in not pregnant state, thyroid-stimulating hormone (TSH) receptor (TSHR) antibodies (TRAbs) are the pathogenetic hallmark of Graves' disease. TRAbs are heterogeneous for molecular and functional properties and are subdivided into activating (TSAbs), blocking (TBAbs), or neutral (N-TRAbs) depending on their effect on TSHR...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28700384/update-on-graves-disease-advances-in-treatment-of-mild-moderate-and-severe-thyroid-eye-disease
#2
Diego Strianese
PURPOSE OF REVIEW: To report the most recent therapeutic advances of thyroid eye disease (TED) and offer general recommendations for management of TED. RECENT FINDINGS: Treatment of Graves ophthalmopathy is traditionally based on the use of high doses of corticosteroids and/or radiotherapy (RT) to decrease the activity of the disease, with the subsequent proptosis, strabismus and eyelid deformites treated with different surgical procedures. In recent years, the evidence that oxidative stress plays a relevant role in exacerbating TED severity has encouraged the use of antioxydative agents such as selenium, which has shown a capacity in limiting the disease progression...
July 11, 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28699420/referral-trends-for-surgical-management-of-graves-disease
#3
Warren C Swegal, Steven S Chang, Michael C Singer
BACKGROUND: Treatment algorithms for Graves' disease (GD) differ internationally and frequency of referral for surgical intervention varies markedly between areas. Given the potential benefits of thyroidectomy over radioactive iodine (RAI) and medical therapy, surgery may be underutilized. To better understand the approach of endocrinologists to GD, we assessed the rationale for consultation among patients referred for thyroidectomy to an endocrine surgery practice in the United States...
July 12, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28670535/effect-of-antithyroid-therapies-on-bone-and-body-composition-a-prospective-randomized-clinical-study-comparing-antithyroid-drugs-with-radioiodine-therapy
#4
Shekhar Kansara, Narendra Kotwal, K V S Hari Kumar, Yashpal Singh, Vimal Upreti, Amit Nachankar
BACKGROUND: Thyrotoxicosis is associated with loss of body weight and bone mineral content (BMC). Antithyroid drugs (ATD) and radioiodine therapy (RIT) are the common options for the management of thyrotoxicosis. We evaluated the effect of ATD and RIT on BMC and body composition. MATERIALS AND METHODS: In this prospective study, we randomized 60 patients of thyrotoxicosis (20-50 years, treatment naïve, males) to receive either ATD (Group 1) using carbimazole or RIT (Group 2)...
July 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28669056/pathogenic-th17-and-th22-cells-are-increased-in-patients-with-autoimmune-thyroid-disorders
#5
Marlen Vitales-Noyola, Ana M Ramos-Levi, Rebeca Martínez-Hernández, Ana Serrano-Somavilla, Miguel Sampedro-Nuñez, Roberto González-Amaro, Mónica Marazuela
PURPOSE: To study the levels of pathogenic and non-pathogenic Th17 and Th22 cells in autoimmune thyroid disorders patients. Although Th17 cells seem to play an important role in the pathogenesis of thyroid autoimmune disorders, the specific subsets of these lymphocytes have not been analyzed in this condition. METHODS: We assessed the levels of Th17 (pathogenic and non-pathogenic) and Th22 cells in peripheral blood and thyroid glands of autoimmune thyroid disorders patients (n   =  26, 16 with Graves' disease and 10 with Hashimoto's thyroiditis) and 15 healthy controls by multi-parametric flow cytometry and immunofluorescence microscopy...
July 1, 2017: Endocrine
https://www.readbyqxmd.com/read/28658823/scintigraphic-profile-of-thyrotoxicosis-patients-and-correlation-with-biochemical-and-sonological-findings
#6
Anil Kumar Avs, Abhish Mohan, P G Kumar, Pankaj Puri
INTRODUCTION: Thyrotoxicosis is a spectrum of disorder with a rather common clinical presentation with different aetiologies. The aetiological diagnosis is important as the management differs. It is essential to accurately diagnose the cause before starting treatment. Scintigraphy of thyroid helps in differentiating accurately the various causes. USG is routinely being advocated and T3/T4 ratio has also been used. AIM: This study aims to evaluate the scintigraphic profile of thyrotoxicosis patients and to correlate biochemical and USG findings with scintigraphy...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28606272/-progression-of-the-pathogenesis-of-thyroid-associated-ophthalmopathy
#7
L Wang, J M Ma
Thyroid associated ophthalmopathy (TAO) is a common complication of Graves' disease (GD). The clinical manifestations are mainly swelling and retracted eyelid, protopsis and limited eye movements, and optic neuropathy can be seen in severe cases. The mechanism of TAO is not yet clear. A large number of studies have found that the disorders of autoimmunity play an important role in TAO, while genetic factors, oxidative stress, and environmental factors such as smoking participate in it. Therefore, we consult a large number of studies and expound the pathogenesis from the aspects of genetic susceptibility, immune mechanism, oxidative stress, and the effects of smoking to provide referrences for clinical associated studies...
June 11, 2017: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
https://www.readbyqxmd.com/read/28588345/neuroanatomic-variations-in-graves-dysthyroid-ophthalmopathy-as-studied-with-mri
#8
Rona Z Silkiss, Alex R Wade
PURPOSE: To evaluate whether patients with Graves' dysthyroid ophthalmopathy (GDO) have changes in brain anatomy that can be assessed by neuroimaging as compared to age-matched controls. METHODS: We examined 10 female, euthyroid patients with GDO and 14 age and gender matched controls using high-resolution structural MRI scanning. An automatic cortical segmentation algorithm was used to estimate the thickness of each subject's gray matter across the brain. The resulting cortical thickness measurements were transferred to a standard reference space via a template-based warping procedure...
August 2016: Transactions of the American Ophthalmological Society
https://www.readbyqxmd.com/read/28572231/thyrotoxicosis-investigation-and-management%C3%A2
#9
REVIEW
Jackie Gilbert
Graves' disease (GD) and toxic nodular (TN) goitre account for most cases of thyrotoxicosis associated with hyperthyroidism. Hyperthyroidism is confirmed with measurement of a suppressed serum thyrotropin concentration (TSH) and elevated free thyroid hormones. The three therapeutic options are antithyroid drugs, radioactive iodine and surgery. Thionamides achieve long-term remission in 35% of cases. Many centres administer fixed doses of iodine-131; larger doses result in improved rates of cure at the cost of hypothyroidism...
June 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28540010/changes-in-choroidal-perfusion-after-orbital-decompression-surgery-for-graves-ophthalmopathy
#10
Narieman Nik, Amelia Fong, Marianna Derdzakyan, Chrysavgi Adamopoulou, Adam Sise, Aziz Khanifar, Reginald Sanders
PURPOSE: To assess choroidal perfusion before and after orbital decompression surgery in patients with Graves' ophthalmopathy. METHODS: In this interventional case series, surgical decompression for optic nerve compromise was performed on four eyes of three patients with Graves' disease. Complete ophthalmic examination including visual acuity, color vision, and intraocular pressure assessment were done pre- and postoperatively. High-speed indocyanine green angiography was performed prior to surgery and was repeated one year after surgery...
April 2017: Journal of Ophthalmic & Vision Research
https://www.readbyqxmd.com/read/28484500/pingmu-decoction-induces-orbital-preadipocytes-apoptosis-in-vitro
#11
Yali Zhang, Hong Li, Long Gao, Xia Zhang, RuiFang Xie
Pingmu Decoction is the Traditional Chinese Medicine which has treated Graves' Ophthalmopathy (GO) in the inactive stage for more than ten years. This study was to explore the mechanism of Pingmu Decoction of inhibiting preadipocytes in GO patients from differentiating into mature adipocytes. Human orbital preadipocytes were isolated and cultured through tissue explant method. Orbital preadipocytes were induced into mature adipocytes. The medicinal serum was prepared from rats. The cells were treated with medicinal serum which were divided into three groups, low dose group (5%), medium dose group (10%), and high dose group (20%)...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28467880/teprotumumab-for-thyroid-associated-ophthalmopathy
#12
RANDOMIZED CONTROLLED TRIAL
Terry J Smith, George J Kahaly, Daniel G Ezra, James C Fleming, Roger A Dailey, Rosa A Tang, Gerald J Harris, Alessandro Antonelli, Mario Salvi, Robert A Goldberg, James W Gigantelli, Steven M Couch, Erin M Shriver, Brent R Hayek, Eric M Hink, Richard M Woodward, Kathleen Gabriel, Guido Magni, Raymond S Douglas
BACKGROUND: Thyroid-associated ophthalmopathy, a condition commonly associated with Graves' disease, remains inadequately treated. Current medical therapies, which primarily consist of glucocorticoids, have limited efficacy and present safety concerns. Inhibition of the insulin-like growth factor I receptor (IGF-IR) is a new therapeutic strategy to attenuate the underlying autoimmune pathogenesis of ophthalmopathy. METHODS: We conducted a multicenter, double-masked, randomized, placebo-controlled trial to determine the efficacy and safety of teprotumumab, a human monoclonal antibody inhibitor of IGF-IR, in patients with active, moderate-to-severe ophthalmopathy...
May 4, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28457178/postoperative-outcomes-in-graves-disease-patients-results-from-the-nationwide-inpatient-sample-database
#13
Gustavo A Rubio, Tulay Koru-Sengul, Tanaz M Vaghaiwalla, Punam P Parikh, Josefina C Farra, John I Lew
BACKGROUND: Current surgical indications for Graves' disease include intractability to medical and/or radioablative therapy, compressive symptoms, and worsening ophthalmopathy. Total thyroidectomy for Graves' disease may be technically challenging and lead to untoward perioperative outcomes. This study examines outcomes in patients with Graves' disease who underwent total thyroidectomy and assesses its safety for this patient population. METHODS: A retrospective cross-sectional analysis was performed using the Nationwide Inpatient Sample database from 2006 to 2011...
June 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28450378/long-term-outcomes-of-orbital-fat-decompression-in-graves-orbitopathy
#14
Anny M Cheng, Yi-Hsuan Wei, Sean Tighe, Hosam Sheha, Shu-Lang Liao
PURPOSE: To evaluate the long-term clinical efficacy of orbital fat decompression in treating proptosis in Graves' ophthalmopathy (GO). METHODS: Retrospective review of 1604 eyes of 845 patients with symmetric (1518 eyes) and asymmetric (86 eyes) proptosis who received orbital fat decompression between 2003 and 2014. Changes in Hertel values were evaluated at baseline, 6 months postoperatively and yearly thereafter. Recurrence of proptosis, diplopia and other complications that required additional surgeries were documented and analysed...
April 27, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/28405484/thyroid-associated-ophthalmopathy
#15
REVIEW
Esra Şahlı, Kaan Gündüz
Thyroid-associated ophthalmopathy is the most frequent extrathyroidal involvement of Graves' disease but it sometimes occurs in euthyroid or hypothyroid patients. Thyroid-associated ophthalmopathy is an autoimmune disorder, but its pathogenesis is not completely understood. Autoimmunity against putative antigens shared by the thyroid and the orbit plays a role in the pathogenesis of disease. There is an increased volume of extraocular muscles, orbital connective and adipose tissues. Clinical findings of thyroid-associated ophthalmopathy are soft tissue involvement, eyelid retraction, proptosis, compressive optic neuropathy, and restrictive myopathy...
April 2017: Turkish Journal of Ophthalmology
https://www.readbyqxmd.com/read/28387769/-99-tc-m-octreotide-scintigraphy-and-serum-eye-muscle-antibodies-in-evaluation-of-active-thyroid-associated-ophthalmopathy
#16
B Sun, Z Zhang, C Dong, Y Zhang, C Yan, S Li
PurposeAs an autoimmune inflammatory disorder, active thyroid-associated ophthalmopathy (TAO) is managed optimally by immunosuppression. In this study, we aimed to evaluate octreotide scintigraphy and the level of serum extraocular muscle antibodies in TAO activity.Patients and methodsThis prospective study comprised 304 patients with active TAO (the clinical activity score; CAS≥3), 73 with inactive TAO (CAS<3), 128 with Graves' disease (GD) without ophthalmopathy, and 100 healthy subjects. Moderate-to-severe active TAO patients (CAS≥5) received intravenous injection of methylprednisolone; mild active patients (3≤CAS≤4) received periocular injection of triamcinolone acetonide...
May 2017: Eye
https://www.readbyqxmd.com/read/28373861/environmental-issues-in-thyroid-diseases
#17
REVIEW
Silvia Martina Ferrari, Poupak Fallahi, Alessandro Antonelli, Salvatore Benvenga
Environmental factors are determinant for the appearance of autoimmune thyroid diseases (AITD) in susceptible subjects. Increased iodine intake, selenium, and vitamin D deficiency, exposure to radiation, from nuclear fallout or due to medical radiation, are environmental factors increasing AITD. Cigarette smoking is associated with Graves' disease and Graves' ophthalmopathy, while it decreases the risk of hypothyroidism and thyroid autoimmunity. Viral infections are important environmental factors in the pathogenesis of AITD, too, particularly human parvovirus B19 (EVB19) and hepatitis C virus...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28346855/tshr-igf-1r-cross-talk-not-igf-1r-stimulating-antibodies-mediates-graves-ophthalmopathy-pathogenesis
#18
Christine C Krieger, Susanne Neumann, Bernice Marcus-Samuels, Marvin C Gershengorn
No abstract text is available yet for this article.
May 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28329893/graves-ophthalmopathy-in-a-paediatric-population
#19
Y Sadeghi, A Obéric, G Theintz, M Hamédani
Background Graves' disease is an autoimmune disorder leading to hyperthyroidism. It is often associated with ophthalmic manifestations. Graves' disease is reported to be rare in the paediatric population. Patients and Methods We performed a retrospective analysis on all patients diagnosed with ophthalmopathy related to Graves' disease at a paediatric age (less than 18 years old) in our institution between 2004 and 2015. Results Eight patients were identified: 6 females and 2 males. The median age at diagnosis was 11...
April 2017: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/28319174/simultaneous-induction-of-graves-hyperthyroidism-and-graves-ophthalmopathy-by-tshr-genetic-immunization-in-balb-c-mice
#20
Nan Xia, Xiaozhen Ye, Xiaohao Hu, Shiyu Song, Hui Xu, Mengyuan Niu, Hongwei Wang, Jian Wang
BACKGROUND: Graves' disease is the most common form of autoimmune thyroid disorder, characterized by hyperthyroidism due to circulating autoantibodies. To address the pathological features and establish a therapeutic approach of this disease, an animal model carrying the phenotype of Graves' disease (GD) in concert with Graves' Ophthalmopathy (GO) will be very important. However, there are no ideal animal models that are currently available. The aim of the present study is to establish an animal model of GD and GO disease, and its pathological features were further characterized...
2017: PloS One
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