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Graves ophthalmopathy

Katarzyna Kapelko-Słowik, Mirosław Słowik, Marek Szaliński, Jarosław Dybko, Dariusz Wołowiec, Iwona Prajs, Anna Bohdanowicz-Pawlak, Monika Biernat, Donata Urbaniak-Kujda
BACKGROUND: Graves' orbitopathy (GO), also known as thyroid-associated ophthalmopathy, is characterized by dramatic tissue reactivity. Both inflammation and tissue remodeling characterize the clinical course of GO. Some data has been found regarding the association of MMPs and TIMPs in GO. MATERIAL AND METHODS: Serum concentrations of MMP-9, MMP-2, TIMP-1, and TIMP-2 were determined by ELISA method. OBJECTIVES: Forty-eight patients (34 females, 14 males, with median age 51...
January 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Andrea Rau, Matthias Klopfer, Niklas Rommel, Mechthild Rau-Fornefeld, Andreas Kolk
BACKGROUND: Graves' disease is a common autoimmune inflammatory condition of the thyroid. About one in four of affected patients also develop orbital symptoms like exophthalmos, proptosis and diplopia - called Graves' Ophthalmopathy. Not all patients respond well to the standard therapy of systemic glucocorticoid administration. The inflammatory swelling of the intraorbital muscles can lead to pressure-induced damage of the optic nerve. Orbital decompression surgery is a therapeutic option for these patients with varying success...
February 27, 2018: BMC Ophthalmology
Aldo Ferreira-Hermosillo, Ruben Casados-V, Pedro Paúl-Gaytán, Victoria Mendoza-Zubieta
BACKGROUND: Exophthalmos, myxedema, and osteoarthropathy syndrome is a very rare condition that is associated with Graves' disease. The presence of dermopathy and the involvement of joint/bone tissues indicate that it seems to be related with the severity of the autoimmune process. Owing to its low incidence, there is a lack of information regarding its treatment and clinical follow-up. Some cases improved after use of high doses of steroids; however, some patients do not respond to this treatment...
February 16, 2018: Journal of Medical Case Reports
Marco Aurélio Ferreira Federige, João Hamilton Romaldini, Ana Beatriz Pinotti Pedro Miklos, Marcia Kiyomi Koike, Kioko Takei, Evandro de Souza Portes
OBJECTIVE: Selenium (Se) supplementation has been used to help prevent the progression of Graves' ophthalmopathy (GO) and autoimmune thyroid diseases (AITD) patients. We investigated Se serum and selenoprotein P (SePP) levels in Graves' disease (GD) with and without GO, Hashimoto's thyroiditis (HT) patients and in 27 control individuals (C). SUBJECTS AND METHODS: We studied 54 female and 19 male patients: 19 with GD without GO, 21 GD with GO, 14 with HT and 19 with HT+LT4...
December 2017: Archives of Endocrinology and Metabolism
Vincenzo Cuccurullo, Giuseppe Danilo Di Stasio, Maria Rosaria Prisco, Luigi Mansi
The somatostatin (SS) receptor scintigraphy (SRS), using octreotide radiolabelled with111 In (Ocreoscan©, OCT), is a consolidated diagnostic procedure in patients with neuroendocrine tumors (NET) because of an increased expression of somatostatin receptors (SS-R) on neoplastic cells. Uptake of SS analogues (SSA) can also be due to SS-R expression on nonmalignant cells when activated as lymphocytes, macrophages, fibroblasts, vascular cells. Because of this uptake, clinical indications can be found either in neoplasms not overexpressing SS-R, as nonsmall cell lung cancer, and in active benign diseases...
October 2017: Indian Journal of Radiology & Imaging
Kalyna Jakibchuk, Sophia Ali, Julie Samantray
A 40-year-old woman with a history of Graves' disease status postorbital decompression for severe ophthalmopathy underwent total thyroidectomy by a high volume thyroid surgeon in July 2013 with a benign final pathology. Eight months later, she presented with a mass on the right anterior neck that showed minimal growth over time. Her thyroid stimulating immunoglobulin and thyroid-stimulating hormone receptor antibody levels were consistently elevated and increasing. She underwent removal of the neck mass in September 2016...
January 23, 2018: BMJ Case Reports
Rehan Rajput, Amun Sachdev, Nizar Din, Erika Marie Damato, Aidan Murray
METHODS: We present a rare case with atypical presenting features of unilateral CPEO with a false positive Acetylcholine Receptor Antibody (AchRA) test resulting in diagnostic delay. We illustrate the unilateral nature of this case and demonstrate the caveats of performing myogenic ptosis correction in such patients. We also discuss the differential diagnosis of false positive AchRA, a test commonly performed in the investigation of ptosis. RESULTS: A 34-year old female presented with a more than 3-year history of slowly-progressive, unilateral, right-sided restriction in eye movements and ptosis...
January 15, 2018: Orbit
Justina Budeniene, Antanas Budenas, Dalia Jarusaitiene
No abstract text is available yet for this article.
December 20, 2017: Medicina Clínica
Michelle Mohyi, Terry J Smith
Thyroid-associated ophthalmopathy (TAO) is a vexing and poorly understood autoimmune process involving the upper face and tissues surrounding the eyes. In TAO, the orbit can become inflamed and undergo substantial remodeling that is disfiguring and can lead to loss of vision. These are currently no approved medical therapies for TAO, the consequence of its uncertain pathogenic nature. It usually presents as a component of the syndrome known as Graves' disease where loss of immune tolerance to the thyrotropin receptor (TSHR) results in the generation of activating antibodies against that protein and hyperthyroidism...
December 22, 2017: Journal of Molecular Endocrinology
Mario R Romano, Gilda Cennamo, Maria Angelica Breve, Michela Piedepalumbo, Claudio Iovino, Nunzio Velotti, Giovanni Cennamo
AIM: To describe the morphological changes of the lamina cribrosa (LC) in patients with optic nerve compression. METHODS: Cross-sectional study. Twenty eyes with optic nerve compression, affected by Graves' ophthalmopathy (GO) were compared with 18 refractive error-matched healthy eyes. The following examinations were performed: best-corrected visual acuity (BCVA), intraocular pressure, optic nerve echography, visual field, SD-OCT including the retinal nerve fiber layer (RNFL), ganglion cell complex (GCC), and LC thickness and extent...
2017: International Journal of Ophthalmology
Jurate Jankauskiene, Dalia Jarusaitiene
Purpose: To investigate juvenile Graves' ophthalmopathy (GO) signs and compare Graves' disease (GD) course in patients with or without GO. Patients and Methods: There were analyzed data (visual acuity, proptosis, palpebral fissure measurements, clinical activity score (CAS), and the course of GD) of 67 children who have been newly diagnosed with GD. 26.9% of patients with GD had signs of ophthalmopathy (GO+), and 73.1% were without ophthalmopathy (GO-). Results: Upper eyelid retraction (72...
2017: Journal of Ophthalmology
P R K Bhargav, M Sabaretnam, S Chandra Kumar, S Zwalitha, N Vimala Devi
Autoimmune ophthalmopathy is one of the salient clinical features associated with Graves' disease. Exophthalmos is one of the commonest manifestations of Graves' associated ophthalmopathy. It is reported to regress after thyroidectomy favourably compared to radioiodine or antithyroid drug therapy. In this context, we present our experience based on a surgical series of Graves' disease. This is a prospective study of 15 patients of Graves' disease associated with ophthalmopathic exophthalmos. Preoperative and monthly postoperative evaluation of exophthalmos was done with Hertel's exophthalmometer, apart from documenting lid, extra-ocular muscle and orbital involvement...
December 2017: Indian Journal of Surgery
Alisha Kamboj, Michael Lause, Priyanka Kumar
Disorders of the endocrine system usually manifest in a multi-organ fashion. More specifically, many endocrinopathies become apparent in the eye first through a variety of distinct pathophysiologic disturbances. The eye provides physicians with valuable clues for the recognition and management of numerous systemic diseases, including many disorders of the endocrine pathway. Recognizing ophthalmic manifestations of endocrine disorders is critical not only for rapid diagnosis and treatment, but also to prevent significant morbidity and mortality...
October 2017: Translational pediatrics
Wei Lin Tay, Aaron Kian Ti Tong, Kei Yiu Douglas Hui, Yu Lin Charlene Tang, Chiaw Ling Chng
Radioactive iodine in the treatment of Graves' disease has been associated with the development of de novo Graves' ophthalmopathy (GO). In this report, we describe five individuals who required extensive ophthalmic treatment for post-RAI de novo GO.
September 2017: Hellenic Journal of Nuclear Medicine
Yong-Jiang Li, Yong Luo, Wei-Min He, Ping Li, Feng Wang
BACKGROUND: Radiation for Graves' ophthalmopathy (GO) has traditionally utilized lateral opposing fields (LOF) or three-dimensional conformal radiotherapy (3DCRT) technique. The current study was conducted to report clinical outcomes and therapeutic effects of intensity modulated radiation therapy (IMRT) in treating GO patients. METHODS: One hundred sixteen patients with GO were treated with IMRT as initial local therapy between July 2010 and August 2013, with a median follow-up of 62 months (range 45-81 months)...
November 6, 2017: Radiation Oncology
Fatimah Eliana, Pradana Suwondo, Asmarinah Asmarinah, Alida Harahap, Samsuridjal Djauzi, Joedo Prihartono, Tjokorda Gde Dalem Pemayun
BACKGROUND: graves' disease (GD) is the most common condition of thyrotoxicosis. The management of GD is initiated with the administration of antithyroid drugs; however, it requires a long time to achieve remission. In reality more than 50% of patients who had remission may be at risk for relapse after the drug is stopped. This study aimed to evaluate the role of clinical factors such as smoking habit, degree of ophtalmopathy, degree of thyroid enlargement; genetic factors such as CTLA-4 gene on nucleotide 49 at codon 17 of exon 1, CTLA-4 gene of promotor -318, TSHR gene polymorphism rs2268458 of intron 1; and immunological factors such as regulatory T cells (Treg) and thyroid receptor antibody (TRAb); that affecting the relapse of patients with Graves' disease in Indonesia...
July 2017: Acta Medica Indonesiana
Tiffany Y Lin, Ning Li, Michael W Yeh, Angela M Leung, Daniel B Rootman
OBJECTIVE: Thyroid eye disease (TED), an autoimmune inflammatory process involving the orbital tissues around the eye, is the most common extra-thyroidal manifestation of Graves' disease (GD). Due to changes in the patient's appearance, TED is a socially and visually disabling condition with significant impacts on quality of life. The aim of this study is to assess predictors of strabismus, a severe manifestation of TED. DESIGN: Single-institution retrospective case-control study...
September 2017: Journal of Clinical & Translational Endocrinology
Wei Lin Tay, Wann Jia Loh, Lianne Ai Ling Lee, Chiaw Ling Chng
We report a patient with Graves' disease who remained persistently hyperthyroid after a total thyroidectomy and also developed de novo Graves' ophthalmopathy 5 months after surgery. She was subsequently found to have a mature cystic teratoma containing struma ovarii after undergoing a total hysterectomy and salpingo-oophorectomy for an incidental ovarian lesion. LEARNING POINTS: It is important to investigate for other causes of primary hyperthyroidism when thyrotoxicosis persists after total thyroidectomy...
2017: Endocrinology, Diabetes & Metabolism Case Reports
Hai-Tao Hao, Yujun Wang, Xufu Wang, Sha Luan, Jianhua Cui, Yu Chen, Ya-Li Cui
The objective of the present study was to observe the therapeutic effect of radiation delivered via a (32)P source on Graves' ophthalmopathy. A(32)P solution was injected into a 10-ml vacuum flask held inside a lead container. A window was cut in the lead, generating a treatment beam. Radiation was given to four areas: The upper and lower orbit (covering ~1/3 of the eyelid) and the inner and outer canthus. Each site received 10 daily doses of 20 cGy. Proptosis was measured by an exophthalmometer and the palpebral aperture was determined with a ruler...
October 2017: Experimental and Therapeutic Medicine
Silvijus Abramavicius, Dzilda Velickiene, Edmundas Kadusevicius
RATIONALE: Treatment choices are limited, when deciding how to manage thyrotoxicosis and moderate to severe Graves ophthalmopathy (GO) with suspected optic nerve damage in patients with elevated liver transaminase levels. The situation become even more complicated, if methimazole induced hepatotoxicity is suspected and intravenous methylprednisolone is co-administrated. PATIENT CONCERNS: A 74-year-old woman presented with spontaneous retro-bulbar pain, eyelid swelling and inconstant diplopia...
September 2017: Medicine (Baltimore)
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