Graves opthalmopathy

PURPOSE: To compare the diagnostic accuracy of peripapillary retinal nerve fiber layer with macular ganglion cell complex thickness as an auxiliary tool for the early diagnosis of dysthyroid optic neuropathy and help assess the effectiveness of the treatment. METHODS: In this retrospective case-control study, a total of 58 thyroid-associated opthalmopathy patients and 58 healthy participants were enrolled in the study. Thyroid-associated opthalmopathy patients were divided according to the European Group Graves' Orbitopathy severity classification...

The purpose of this investigation was to explore the combined effects of single nucleotide polymorphisms (SNPs) within LFA-1/ICAM-1/GSK-3β pathway and environmental hazards on susceptibility to Graves' opthalmopathy (GO) among a Chinese Han population. Altogether 305 GO patients and 283 Graves' disease (GD) subjects were recruited. Information relevant to the participants' age, gender, body mass index (BMI), regular physical activity, smoking history, alcohol intake, stressful work environment, stress at work, family history of thyroid disease and 131 I treatment were summarized, and the participants' related SNPs of LFA-1/ICAM-1/GSK-3β were also detected...

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.

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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...

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...

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...

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...

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...

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.

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...