open access

Vol 57, No 5 (2006)
Case report
Published online: 2006-11-06
Submitted: 2013-02-15
Get Citation

A special case of thyroid associated ophthalmopathy in the course of Graves-Basedow disease

Agata Bałdys-Waligórska, Beata Kuśnierz-Cabala, Bohdan Huszno
Endokrynologia Polska 2006;57(5):536-540.

open access

Vol 57, No 5 (2006)
Case report
Published online: 2006-11-06
Submitted: 2013-02-15

Abstract

Introduction: The exact pathogenesis of Graves’ ophthalmopathy and the possibility of causal treatment of this disease still remain unclear. Currently no standard treatment guidelines have been accepted. While treatment procedures have been established in specialized centres, management of complicated and long-lasting cases is always individual. We present an unusual case of Graves’ ophthalmopathy accompanied by other autoimmune diseases.
Case report: Our patient, MB, female, born in 1961, was diagnosed with Graves’ disease 13 years ago. Recurrent hyperthyroidism and large goitre qualified her for strumectomy (performed twice) and long-term antithyroid treatment. Four years after her initial diagnosis, relapsing severe (ophthalmopathy index: 9 points, CAS: 7 points) occurred which persisted despite continuous administration of glucocorticoids. Due to imminent blindness, orbital decompression had to be performed, three times since. Concurrent autoimmune diseases: ulcerative colitis and seronegative rheumatoid arthritis were also stated. Two years ago, due to loss of vision acuity, rapid progression of exophthalmos and recurrence of hyperthyroidism, immunosuppressive treatment with azathioprine was undertaken over a period of 12 months. The present condition of the patient is satisfactory.
Conclusion: Judging from the discussed course of treatment, in rare and difficult cases of proliferative ophthalmopathy, early immunosuppressive treatment other than glucocorticoids, should be considered.

Abstract

Introduction: The exact pathogenesis of Graves’ ophthalmopathy and the possibility of causal treatment of this disease still remain unclear. Currently no standard treatment guidelines have been accepted. While treatment procedures have been established in specialized centres, management of complicated and long-lasting cases is always individual. We present an unusual case of Graves’ ophthalmopathy accompanied by other autoimmune diseases.
Case report: Our patient, MB, female, born in 1961, was diagnosed with Graves’ disease 13 years ago. Recurrent hyperthyroidism and large goitre qualified her for strumectomy (performed twice) and long-term antithyroid treatment. Four years after her initial diagnosis, relapsing severe (ophthalmopathy index: 9 points, CAS: 7 points) occurred which persisted despite continuous administration of glucocorticoids. Due to imminent blindness, orbital decompression had to be performed, three times since. Concurrent autoimmune diseases: ulcerative colitis and seronegative rheumatoid arthritis were also stated. Two years ago, due to loss of vision acuity, rapid progression of exophthalmos and recurrence of hyperthyroidism, immunosuppressive treatment with azathioprine was undertaken over a period of 12 months. The present condition of the patient is satisfactory.
Conclusion: Judging from the discussed course of treatment, in rare and difficult cases of proliferative ophthalmopathy, early immunosuppressive treatment other than glucocorticoids, should be considered.
Get Citation

Keywords

Graves disease; thyroid associated ophthalmopathy; autoimmune diseases

About this article
Title

A special case of thyroid associated ophthalmopathy in the course of Graves-Basedow disease

Journal

Endokrynologia Polska

Issue

Vol 57, No 5 (2006)

Pages

536-540

Published online

2006-11-06

Bibliographic record

Endokrynologia Polska 2006;57(5):536-540.

Keywords

Graves disease
thyroid associated ophthalmopathy
autoimmune diseases

Authors

Agata Bałdys-Waligórska
Beata Kuśnierz-Cabala
Bohdan Huszno

Important: This website uses cookies.tanya dokter More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Via MedicaWydawcą serwisu jest  "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl