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Graves eye disease

Nadia Sawicka-Gutaj, Mirosław Andrusiewicz, Agata Czarnywojtek, Joanna Waligórska-Stachura, Maciej Biczysko, Jerzy Skrobisz, Jerzy Sowiński, Marek Ruchała
Purpose: Our aim was to analyze NAMPT expression in thyroid tissue derived from patients with Graves' disease with (GD) and without (GO) orbitopathy, patients with toxic nodular goiters (TNG) and thyroid cancers (TC), and healthy controls. Methods: 153 thyroid tissue samples of consecutive patients who underwent thyroidectomy were collected. Previous therapy with steroids was an exclusion criterion. We collected clinicopathological data of all subjects and we assessed NAMPT expression using qPCR...
2018: BioMed Research International
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
Edith Mawunyo Ackuaku-Dogbe, Josephine Akpalu, Benjamin Abaidoo
PURPOSE: Thyroid-associated orbitopathy (TAO), a clinical manifestation of Graves' disease, is an autoimmune disorder of the orbital and periorbital tissue. Data on the epidemiology and clinical presentation of TAO in Africa are generally scarce and unavailable in Ghana. We investigated the epidemiology and clinical features of TAO among patients with thyroid disorders attending the Korle Bu Teaching Hospital, Accra. SUBJECTS AND METHODS: This was a descriptive cross-sectional study of patients diagnosed with thyroid disorders which was conducted at the endocrine and orbital clinics of the Korle Bu Teaching Hospital...
October 2017: Middle East African Journal of Ophthalmology
Shuo Zhang, Yang Wang, Sisi Zhong, Xingtong Liu, Yazhuo Huang, Sijie Fang, Ai Zhuang, Yinwei Li, Jing Sun, Huifang Zhou, Xianqun Fan
BACKGROUND: Thyroid eye disease (TED) is a debilitating autoimmune orbital disease that is often a result of Graves' disease. Dysthyroid optic neuropathy (DON) is a rare but sight-threatening manifestation of TED with therapeutic challenges that can potentially lead to visual loss. CASE PRESENTATION: A 74-year-old man experienced active TED with extremely severe redness and swelling of the conjunctiva, loss of visual acuity and exacerbation of disfiguring proptosis...
February 6, 2018: BMC Endocrine Disorders
Eszter Berta, Miklós Bodor, László Galuska, György Paragh, Annamária Erdei, Annamária Gazdag, Bernadett Ujhelyi, Ervin Berényi, Mónika Katkó, Andrea Gazsó, Endre V Nagy
PURPOSE: Graves' orbitopathy (GO) is a complication of Graves' disease (GD), the development of which cannot be predicted at the time of diagnosis of GD. Our aims were (i) to test if orbital 99mTc-labelled diethylenetriamine pentaacetic acid single-photon emission computer tomography (DTPA SPECT) can predict development of GO later during the course of the disease and (ii) to study whether orbital immune activity can be detected in GD patients who do not develop GO during follow-up. METHODS: Fifty-four orbits of 27 patients with newly diagnosed GD were entered into the case-control study...
January 31, 2018: Experimental and Clinical Endocrinology & Diabetes
Karolina Stożek, Artur Bossowski, Katarzyna Ziora, Anna Bossowska, Małgorzata Mrugacz, Anna Noczyńska, Mieczysław Walczak, Elżbieta Petriczko, Beata Pyrżak, Anna Kucharska, Mieczysław Szalecki, Tanja Diana, George J Kahaly
INTRODUCTION: The diagnostic value of the level of TSH receptor antibodies (TSHR-Ab) in the population of children with autoimmune thyroid diseases (AITDs) is still unknown. The aim of this cross-sectional study was to investigate the prevalence of TSHR-Ab in a paediatric cohort with AITD and healthy controls. MATERIALS AND METHODS: A total of 240 serum samples were obtained from 205 patients with AITD, type 1 diabetes (T1D), juvenile arthritis (JA), and healthy controls (C)...
January 26, 2018: Autoimmunity
Annamaria Erdei, Zita Steiber, Csaba Molnar, Ervin Berenyi, Endre V Nagy
BACKGROUND: Immunoglobulin G4-related disease (IgG4-rd) is characterized by lymphoplasmacytic infiltration and tissue fibrosis. Orbital manifestations of IgG4-rd may include unilateral or bilateral proptosis, cicatricial extraocular muscle myopathy, orbital inflammation and pain which may mimic ophthalmic Graves' disease. CASE PRESENTATION: A 25-year-old woman has been referred to the endocrinology clinic, 4 months after delivery, with suspected Graves' orbitopathy...
January 12, 2018: BMC Ophthalmology
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
Nadia Daldoul, Leila Knani, Faten Gatfaoui, Hechmi Mahjoub
Our study aimed to describe the therapeutic management of moderate and severe dysthyroid orbitopathies and to evaluate the factors associated with optic neuropathy as well as the prognostic factors of poor visual outcome using a statistical analysis. We conducted a retrospective study of 22 patients presenting with moderate to severe dysthyroid orbitopathy in at least one eye and hospitalized in the Department of Ophthalmology at the University Hospital Farhat Hached, Sousse over the period from 1998 to 2015...
2017: Pan African Medical Journal
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
Sarra Gattoussi, Quraish Ghadiali, Rosa Dolz-Marco, K Bailey Freund
PURPOSE: We describe with multimodal imaging the presentation and follow-up for a patient with idiopathic multifocal choroiditis and a transient peripapillary white ring. METHODS: Case report. RESULTS: A 39-year-old Asian woman was initially seen for an evaluation of lattice degeneration in 2015. Her medical history included Graves disease and psoriasis. Best-corrected visual acuity was 20/25 in her right eye and 20/25 in her left eye. Ultra-widefield fundus autofluorescence imaging showed a curvilinear hyperautofluorescent line in her right eye...
November 22, 2017: Retinal Cases & Brief Reports
Enke Baldini, Teresa Odorisio, Salvatore Sorrenti, Antonio Catania, Francesco Tartaglia, Giovanni Carbotta, Daniele Pironi, Roberta Rendina, Eleonora D'Armiento, Severino Persechino, Salvatore Ulisse
Vitiligo represents the most common cause of acquired skin, hair, and oral depigmentation, affecting 0.5-1% of the population worldwide. It is clinically characterized by the appearance of disfiguring circumscribed skin macules following melanocyte destruction by autoreactive cytotoxic T lymphocytes. Patients affected by vitiligo usually show a poorer quality of life and are more likely to suffer from depressive symptoms, particularly evident in dark-skinned individuals. Although vitiligo is a non-fatal disease, exposure of affected skin to UV light increases the chance of skin irritation and predisposes to skin cancer...
2017: Frontiers in Endocrinology
Morgan Yang, Yvonne Chung, Stephanie Lang, Nobuyo Yawata, Lay Leng Seah, Audrey Looi
PURPOSE: The primary aim of this study is to isolate cytokines specific for active Graves' orbitopathy (GO) in the tears of affected patients. The secondary aim is to identify other cytokines of interest and to look at the profile of their levels over time. METHODS: This is a prospective pilot study conducted at the Singapore National Eye Centre. A total of 10 patients with active GO and 10 patients from each of 3 control groups were recruited. The 3 control groups were the following: age-matched normal female patients, patients with GO who were clinically inactive and patients with bilateral viral conjunctivitis...
November 16, 2017: Endocrine
Jan Jiskra
Graves orbitopathy (GO) occurs in 25-50 % cases of Graves disease. Only in 5 % of patients the eye threatening GO is present. About 5-10 % and 10 % cases are present in euthyroid and hypothyroid patients respectively. All patients with GO should be assessed for activity (clinical activity score - CAS) and severity of the disease. Basic preconditions of the treatment are maintenance of euthyroidism, an effort to stop smoking, and referring of patients with moderate to severe and sight threatening GO to specialized thyroid eye centers...
2017: Vnitr̆ní Lékar̆ství
Hong Li, Yali Zhang, Jie Min, Long Gao, Ren Zhang, Yucheng Yang
INTRODUCTION: Graves' orbitopathy (GO) is an autoimmune inflammatory disorder affecting the orbit around the eye. Astragaloside IV (AS-VI) is the main active ingredient of the Chinese herbal medicine Huangqi (Radix Astragali Mongolici). AS-IV exhibits antioxidant and anti-inflammatory properties, and shows therapeutic potential in a number of ischemic and inflammatory diseases; however, its pharmaceutical activities in GO remain undefined. MATERIALS AND METHODS: In this study, we investigated the effects of AS-IV on interleukin (IL)-1β-induced orbital fibroblast inflammation in vitro and GO orbital inflammation and ocular histopathological changes in vivo, as well as the underlying mechanisms responsible for these effects...
November 10, 2017: Inflammation Research: Official Journal of the European Histamine Research Society ... [et Al.]
A A McNab
A very large number of disorders affect the orbit, and many of these occur in the setting of systemic disease. This lecture covers selected aspects of orbital diseases with systemic associations in which the author has a particular clinical or research interest. Spontaneous orbital haemorrhage often occurs in the presence of bleeding diatheses. Thrombosis of orbital veins and ischaemic necrosis of orbital and ocular adnexal tissues occur with thrombophilic disorders, vasculitis, and certain bacterial and fungal infections...
February 2018: Eye
Juliette Delmas, Jean-Marie Loustau, Sylvain Martin, Loïc Bourmault, Jean-Paul Adenis, Pierre-Yves Robert
PURPOSE: Accurate and reproducible exophthalmometry is mandatory to diagnose and follow-up orbital patients, especially in Graves disease. However, many variations are described among the different commercially available exophthalmometers. METHODS: Sixty patients, who underwent a cerebral computed tomography (CT) scan, were included. External prebicanthal segments (EPBCS) for right and left eyes (RE and LE), interorbital distance, and globe axial length were recorded by a first observer (O1), more experienced than a second (O2)...
November 2, 2017: European Journal of Ophthalmology
Elena Sabini, Marenza Leo, Barbara Mazzi, Roberto Rocchi, Francesco Latrofa, Marco Nardi, Paolo Vitti, Claudio Marcocci, Michele Marinò
OBJECTIVES: There is a general belief that Graves' orbitopathy (GO) is a "chronic" disease, namely that patients' eyes do not return to how they were before GO appeared. Here, we investigate this issue from both the patient's and the physician's point of view. STUDY DESIGN: We studied the disappearance of GO, regardless of treatment, in all consecutive patients with a GO history of at least 10 years who came for a follow-up visit over a period of 5 years. Patients underwent an ophthalmological examination and were asked to answer a questionnaire on self-perception related to GO...
September 2017: European Thyroid Journal
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
Geraldine R Slean, Rona Z Silkiss
Several antineoplastic treatments have been responsible for thyroid dysfunction and thyroid eye disease. Min, Vaidya, and Becker (2011) reported a case of euthyroid Graves orbitopathy after treatment with ipilimumab with the patient displaying proptosis and myositis in the setting of normal thyroid function tests and elevated thyroid antibodies. The authors report a case of a 76-year-old woman who developed right upper lid retraction and proptosis after 2.5 years of treatment with lenalidomide for multiple myeloma...
October 19, 2017: Ophthalmic Plastic and Reconstructive Surgery
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