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Graves opthalmopathy

Rajashekara Babu Gangappa, Manjunath Basavaraj Kenchannavar, Prashanth Basappa Chowdary, Adithya Malolan Patanki, Mahalakshmi Ishwar
INTRODUCTION: Total thyroidectomy has been used to treat patients with malignant thyroid disease. But for patients with benign thyroid disease, the safety and efficacy of total thyroidectomy is a matter of debate. Subtotal thyroidectomy that was previously the treatment of choice for benign thyroid disease has been associated with high recurrence rates. The risk of permanent complications is greatly increased in patients who undergo surgery for recurrence of benign thyroid disease. Total thyroidectomy is an operation that can be safely performed, with low incidence of permanent complications, which allows one to broaden its indications in various benign thyroid diseases, thus avoiding future recurrences and reoperations...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
Lorenz, Dralle
The concept of therapy for hyperthyroidism combines endocrinology, nuclearmedicine and surgery. For selection of the treatment of choice, pathophysiology as well as individual aspects are considered. Surgical therapy is mainly concerned with treatment of functional autonomy, Grave's disease and iodine-excess-related hyperthyroidism based on either autonomous or Grave's disease. For each of these three main groups of hyperthyroidism exist differentiated surgical concepts based on the underlying thyroid disease and its course: The various forms of functional autonomy, solitary autonomous nodules, multifocal autonomy or dissiminated autonomy are dealt with selective enucleation-resection, functionally and morphologically oriented resection and extensive resection with little remaining thyroid tissue of about 5-6 ml, respectively...
July 1, 1999: Therapeutische Umschau. Revue Thérapeutique
Malik Mumtaz, Lim Shueh Lin, Khaw Chong Hui, Amir Sharifuddin Mohd Khir
Graves' disease is a common cause of hyperthyroidism. Treatment options for Graves' disease include antithyroid medication, surgery or radioactive iodine (I-31) or RAI. This review will focus on the approach to RAI therapy; discussing dose selection, patient preparation, and consideration before and after administering RAI, examining aspects of pre-treatment with antithyroid medication as well as discussing possible adverse events including hypothyroidism and possible worsening of thyroid-associated opthalmopathy...
January 2009: Malaysian Journal of Medical Sciences: MJMS
A Polymeris, E Karoutsou, K Doumouchtsis
Graves' disease (GD) and myasthenia gravis (MG) are common autoimmune diseases but their coexistence is very rare. They may possibly share the same pathogenetic mechanisms. Recent research has shown the involvement of autoantibodies, lymphocytes, cytokines and chemokines in the pathogenesis of MG and GD. It appears that Th17 cell lineage is involved in autoimmune thyroid disease (AITD) and seems to be key factor in the development of both MG and GD.A 34-year-old male with seronegative myasthenia gravis due to thymic hyperplasia was diagnosed with also GD and opthalmopathy...
May 2012: Experimental and Clinical Endocrinology & Diabetes
Stelios Tigas, Petros Papachilleos, Nikolaos Ligkros, Maria Andrikoula, Agathocles Tsatsoulis
Glucocorticoids are commonly used in the treatment of patients with thyroid disorders, in particular Graves' ophthalmopathy. Thyrotoxic hypokalemic periodic paralysis (TPP) is an infrequent but potentially serious condition characterised by recurrent episodes of weakness associated with hypokalemia. We describe the development of acute hypokalemic paralysis in a middle-aged Caucasian man with recently diagnosed thyrotoxicosis and severe, active Graves' opthalmopathy who developed progressive flaccid paralysis 12 hours following intravenous administration of methylprednisolone...
October 2011: Hormones: International Journal of Endocrinology and Metabolism
M K Dutta, Abhay Gundgurthi, M K Garg, N Kotwal
Graves' disease in childhood is a rare clinical entity. The authors report a case of Graves' disease in a 3-year-old child, who had opththalmopathy, accelerated growth, cervical lymphadenopathy, hepatosplenomegaly and congestive cardiac failure; and responded well to treatment.
May 2012: Indian Journal of Pediatrics
Jing Liu, Anna Bargren, Sarah Schaefer, Herbert Chen, Rebecca S Sippel
BACKGROUND: Thyroidectomy as a first line treatment for Graves' disease is rarely utilized in the US. The purpose of this study was to analyze the safety and efficacy of thyroid surgery among patients with Graves' disease. METHODS: Fifty-six patients with Graves' disease underwent thyroid surgery between May 1994 and May 2008 at a single academic institution. Preoperative, intraoperative, and postoperative variables were analyzed. RESULTS: A total of 58 surgeries were performed: 55...
June 1, 2011: Journal of Surgical Research
Asaad A Ghanem, Mostafa A Amr, Lamiaa F Araafa
PURPOSE: To assess the psychiatric and endocrinological changes in patients with Graves ophthalmopathy (GO). DESIGN: A prospective, controlled, University Hospital based study SUBJECTS AND METHODS: The current study comprised 60 patients diagnosed with GO at Mansoura Ophthalmic Center. Thirty five patients of them with moderate to severe GO formed the study group and twenty five patients with negligible to very mild GO formed the control group in the euthyroid state...
April 2010: Middle East African Journal of Ophthalmology
Erol Arslan, Irfan Yavaşoğlu, Burak Mehmet Cildağ, Tolga Kocatürk
Graves' disease is generally seen in women between the ages of 20 and 50 years. Euthyroid Graves' opthalmopathy is seen in 3% of the patients and 10% of the cases are unilateral. Although optic neuropathy is rare and is seen at the later stages of the disease, it is a detrimental complication. Herein, we report a 43-year-old man with right-sided vision loss who was eventually diagnosed to have optic neuropathy as the initial manifestation of euthyroid Graves' disease. Graves' disease should be considered in the differential diagnosis of optic neuropathy of unknown origin...
2009: Internal Medicine
Chao Ma, Anren Kuang, Jiawei Xie, Guanjian Liu
BACKGROUND: Pediatric Graves' disease (GD) is an autoimmune disease in which excessive amounts of thyroid hormones circulate in the blood. Treatments for pediatric GD include antithyroid drugs (ATD), thyroidectomy and radioiodine. Up to date, the optimal therapy remains controversial. OBJECTIVES: To assess the effects of radioiodine treatment for pediatric GD. SEARCH STRATEGY: Studies were obtained from computerized searches of MEDLINE, EMBASE, The Cochrane Library, China National Infrastructure (CNKI) and paper collections of conferences held in Chinese...
2008: Cochrane Database of Systematic Reviews
Claus H Nielsen, Daniel El Fassi, Hans C Hasselbalch, Klaus Bendtzen, Laszlo Hegedüs
In this review, the authors summarise the clinical results obtained after therapy with rituximab in autoimmune diseases, including Graves' disease and Graves' ophthalmopathy. On the basis of qualitative and quantitative analyses of B- and T-cell subsets, and autoantibody levels obtained in other diseases before and after rituximab therapy, the authors interpret the results of the only two clinical investigations of the efficacy of rituximab in the treatment of Graves' disease and Graves' opthalmopathy reported so far...
July 2007: Expert Opinion on Biological Therapy
Qin Xie, Shuang-Qing Li, Zhen-Mei Aa, Song-Quan Wei, Hong-Li Zhao
OBJECTIVE: To investigate the mechanism of Graves' ophthalmopathy (GO) and the relationship between serum IL-1 ra and IL-1beta and the effectiveness of glucocoids in treating GO. METHODS: Serum IL-1ra and IL-1beta were measured by Enzyme linked immunosorbent assay (ELISA) and Radioimmunoassay (RIA) in three groups of people, which included 20 patients with severe GO (NOSPACES> or = IV), 20 patients with Graves' disease (GD) without ophthalmopathy, and 20 healthy volunteers...
March 2006: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
D Kapoor, T H Jones
Smoking has multiple effects on hormone secretion, some of which are associated with important clinical implications. These effects are mainly mediated by the pharmacological action of nicotine and also by toxins such as thiocyanate. Smoking affects pituitary, thyroid, adrenal, testicular and ovarian function, calcium metabolism and the action of insulin. The major salient clinical effects are the increased risk and severity of Graves' hyperthyroidism and opthalmopathy, osteoporosis and reduced fertility. Smoking also contributes to the development of insulin resistance and hence type 2 diabetes mellitus...
April 2005: European Journal of Endocrinology
G E Krassas
Somatostatin (SM), a peptide inhibiting the release of GH, is present and plays an inhibitory role in the regulation of several organ systems in men and other species. Various SM analogs (SM-As) have been developed and used in clinical practice because the short half-life of SM makes it unsuitable for routine treatment. Recently it has been shown that SM-As might be of therapeutic value in the treatment of active thyroid ophthalmopathy. So far, 61 patients have been treated with octreotide and the results have been published in the literature...
March 2004: Journal of Endocrinological Investigation
João R M Martins, Reinaldo P Furlanetto, Lhoyane M Oliveira, Aline Mendes, Carlo C Passerotti, Maria Izabel Chiamolera, Antonio J Rocha, Paulo G Manso, Helena B Nader, Carl P Dietrich, Rui M B Maciel
OBJECTIVE: Immunosuppressive treatment of Graves' opthalmopathy (GO) should be restricted to patients with active eye disease, but assessing disease activity is difficult. Several methods to evaluate GO activity have been introduced, but none of them is satisfactory. Glycosaminoglycans (GAGs) are complex polysaccharides that participate on the pathogenesis of GO and attempts to correlate its local increase to urinary GAGs (uGAGs) or serum hyaluronan (sHA) have been made, but the available techniques are labourious, time-consuming and difficult for routine use...
June 2004: Clinical Endocrinology
Yuuki Takamura, Keiichi Nakano, Takashi Uruno, Yasuhiro Ito, Akihiro Miya, Kaoru Kobayashi, Tamotsu Yokozawa, Fumio Matsuzuka, Kanji Kuma, Akira Miyauchi
TSH receptor antibodies (TRAb) are generally regarded as mediators of thyroid stimulation in Graves' disease. In addition, a high serum TRAb value during pregnancy is one of the risk factors for intrauterine death, prematurity, and fetal or neonatal hyperthyroidism. Recently, correlations between a high serum TRAb value and endocrine opthalmopathy were also suggested. Surgical resection of the thyroid is usually followed by a reduction of serum TRAb levels in variable degrees. The relation between the extent of the thyroidectomy and the degree of reduction is still controversial...
October 2003: Endocrine Journal
Miho Nakai, Yosuke Okada, Takahisa Tanikawa, Kazuko Kanda, Emiko Morita, Yoshiya Tanaka
Graves' ophthalmopathy in hypothyroid state is called Hypothyroid Graves' Disease, which is a comparatively rare disease. We experienced a case of a 57 year old man with severe exophthalmos and diplopia, which are typical symptoms of Graves' opthalmopathy, and with an extremely high thyroid-stimulating antibody(TSAb) level. He also had a firm diffuse goiter and hypothyroidism with positive anti-thyroglobulin and anti-thyroid microsomal antigen. These findings suggested Hashimoto's thyroiditis. Severity of ophthalmopathy and TSAb level were improved during replacement therapy with T4...
September 1, 2003: Journal of UOEH
S-M Huang, T-J Wu, T D Lee, E K L Yang, C-K Shaw, C-C Yeh
Graves' disease has been associated with different human leukocyte antigen (HLA) genes in different races. To evaluate the association of HLA type in Taiwanese with Graves' disease, the HLA-A, -B, and -DRB1 alleles in a total of 236 Taiwanese adults with Graves' disease and 533 racially matched normal control subjects were examined using the PCR-SSOP (sequence specific oligonucleotide probe) technique. The prevalence of HLA-A*0207, -B*2704, -B*4601, and -DRB1*0901 among patients with Graves' disease was found to be increased, with odds ratios (OR) of 2...
February 2003: Tissue Antigens
Wilmar M Wiersinga, Luigi Bartalena
Graves' ophthalmopathy is clinically relevant in approximately 50% of patients with Graves' disease, severe forms affecting 3%-5% of patients. Two age peaks of incidence are observed in the fifth and seventh decades of life, with slight differences between women and men. The disease is more frequent in women than in men, although the female-to-male ratio is only 1:4 in severe forms of eye disease. The natural history of Graves' ophthalmopathy is incompletely defined, but in many instances, especially in mild forms, the disease may remit or improve spontaneously...
October 2002: Thyroid: Official Journal of the American Thyroid Association
Wilmar M Wiersinga, Mark F Prummel
The past decade has witnessed great progress in our understanding of Graves' opthalmopathy (GO), although its precise immunopathogenesis remains an enigma. Several clinical studies have provided a more rational basis for treatment of this distressing disease, which significantly lowers the quality of life. A management plan tailored to the patient's needs can be devised according to the severity and activity of the eye disease. In active GO, immunosuppression might be considered. The combination of intravenous pulses of methylprednisolone and retrobulbar irradiation improves eye changes in 88% of patients, and is well tolerated...
September 2002: Trends in Endocrinology and Metabolism: TEM
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