Hashimoto's Thyroiditis in Association with Tolosa Hunt Syndrome: A Case Report

Vailati, A; Marena, Carlo; Comis, Silvia; Aristia, L; Sozzé, E; Galenda, P; Martignoni, E.; Bossolo, P. A.; Ascari, E

doi:10.1089/thy.1993.3.125

Cited by 14 publications

(6 citation statements)

References 17 publications

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“…There seems to be no consistent link to an infectious organism 8. Few associations with other inflammatory disorders, such as systemic lupus erythematosus (SLE), Hashimoto thyroiditis, Hodgkin lymphoma and rheumatoid polyarthritis, have been reported; hence, an autoimmune aetiology has been suggested, but is still unclear 9. Traumatic injury has also been associated as a potential trigger for THS 10.…”

Section: Discussionmentioning

confidence: 99%

Tolosa-Hunt syndrome relapse during pregnancy following chronic intake of combined oral contraceptives

2021

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Tolosa-Hunt syndrome (THS) is a rare syndrome of painful ophthalmoplegia secondary to an idiopathic granulomatous inflammation affecting the cavernous sinus, superior orbital fissure or orbit. Pregnancy and pregnancy-related hormones have been identified as potential triggers. A 39-year-old gravida-2 para-1 woman with prior chronic intake of combined oral contraceptives (COC) suffered two episodes of painful ophthalmoplegia—the first event with spontaneous remission and the relapse occurring during pregnancy and with complete resolution following steroid treatment. MRI revealed a postinflammatory mass at the junction of the left orbital apex and anterior cavernous sinus, supporting the diagnosis of THS. To our knowledge, this is the first report of a THS relapse occurring during pregnancy following a chronic history of COC intake. This case adds to the growing evidence supporting the relationship between immune and hormonal factors that may be present during pregnancy and the disease pathogenesis of THS.

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Section: Discussionmentioning

confidence: 99%

Tolosa-Hunt syndrome relapse during pregnancy following chronic intake of combined oral contraceptives

2021

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“…It has been proposed that as the cavernous sinus lesions of THS often extend to the orbital apex and the posterior orbit, they show similar signal intensity characteristics and steroid responsiveness as idiopathic orbital pseudotumours; these two conditions probably are a range of the same disease process 7,10 . Additionally, some authors have shown possible relationships between THS and idiopathic hypertrophic pachymeningitis of the middle cranial fossa, 10,11 vasculitis and autoimmune disease, 12 and inflammatory reactions due to rupture of Rathke’s cleft cyst 13…”

Section: Discussionmentioning

confidence: 99%

Tolosa–Hunt syndrome: MRI appearances

et al. 2008

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A review of MRI findings in seven patients with Tolosa-Hunt syndrome was carried out. Seven patients presented with unilateral painful ophthalmoplegia. Magnetic resonance imaging studies were carried out to evaluate the cavernous sinuses and orbits. Coronal fast spin-echo T2-weighted images and fat-saturated T1-weighted coronal and transverse images with and without contrast enhancement were obtained for the cavernous sinuses and orbits. All patients showed focal-enhancing masses expanding the ipsilateral cavernous sinus. In one patient the mass was extending to the orbital apex and intraorbitally. All patients recovered on corticosteroid therapy and resolution of the masses was documented on follow-up MRI studies in five patients. One patient had a relapse of symptoms after discontinuing therapy. Magnetic resonance imaging studies of the cavernous sinus and orbital apex show high sensitivity for the detection and follow up of inflammatory mass lesions in Tolosa-Hunt syndrome. Magnetic resonance imaging should be the initial screening study in these patients.

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“…It is important to remember that Tolosa-Hunt syndrome is a constellation of symptoms and signs and has been reported in association with a number of conditions. [30][31][32][33][34][35][36][37][38][39][40][41] proposed that Tolosa-Hunt syndrome might represent a focal manifestation of idiopathic pachymeningitis. 29 Even though our experience is anecdotal, from our experience and from the review of the literature, we feel that the nosologic entity of Tolosa-Hunt syndrome might represent one manifestation of idiopathic hypertrophic cranial pachymeningitis and further studies are required to clarify its aetiology.…”

Section: Discussionmentioning

confidence: 99%