Severe thyroid-associated orbitopathy in Hashimoto's thyroiditis. Report of 2 cases

Yoshihara, Ai; Noh, Jaeduk Yoshimura; Nakachi, Ayako; Ohye, Hidemi; Sato, Syozo; Sekiya, Keizo; Kosuga, Yuka; Suzuki, Miho; Matsumoto, Masako; Kunii, Yo; Watanabe, Natsuko; Mukasa, Koji; Inoue, Yoshio; Ito, Kunihiko; Ito, Koichi

doi:10.1507/endocrj.k11e-019

Cited by 37 publications

(20 citation statements)

References 27 publications

(26 reference statements)

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“…Single studies have suggested that euthyroid and primarily hypothyroid patients develop milder and significantly more asymmetrical TAO (6,19). Severe TAO is rare in these cases but a few case reports have described primarily euthyroid or hypothyroid TAO patients with clinically severe TAO requiring systemic immunosuppression (20). Data on eu-or hypothyroid TAO are warranted to gain information pertaining to the changes within the orbit and to evaluate if the latter may be due to TRAb or if other pathogenic mechanisms may be responsible for TAO in patients without autoimmune induced hyperthyroidism.…”

Section: Introductionmentioning

confidence: 99%

Prevalence, Phenotype, and Psychosocial Well-Being in Euthyroid/Hypothyroid Thyroid-Associated Orbitopathy

Ponto

Binder

Diana

et al. 2015

Thyroid

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Section: Introductionmentioning

confidence: 99%

Prevalence, Phenotype, and Psychosocial Well-Being in Euthyroid/Hypothyroid Thyroid-Associated Orbitopathy

Ponto

Binder

Diana

et al. 2015

Thyroid

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“…The differences in clinical and MR imaging features are summarized in Table 2 (3). Due to the patient's history of GD, a diagnosis of TED was initially suspected in this case. There is a case report of severe TED in which only TgAb and TPOAb were detected, not TRAb and TSAb (6). A diagnosis of TED could not be excluded based on the negative results of TRAb and TSAb in our case.…”

Section: Discussionmentioning

confidence: 57%

Idiopathic Orbital Myositis Associated with Graves' Disease

et al. 2013

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A 52-year-old man was referred to our clinic. One week before his visit, he had complained of left eye pain and double vision. His clinical features were exacerbated. Despite the acute onset, which is atypical of thyroid eye disease (TED), TED was suspected due to the patient's history of Graves' disease (GD). After conducting clinical examinations and orbital magnetic resonance imaging, the patient was diagnosed with idiopathic orbital myositis (IOM), and intravenous glucocorticoid therapy was administered. After treatment, the patient's clinical manifestations dramatically improved. This is a rare case in that the history of GD made it difficult to differentiate IOM from TED.

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“…Although in cases of severe TED, patients with negative TSHRab have been reported [9] a more recent large series found that TSHRab measured with a bioassay was strongly associated with TED in HT, suggesting that the association was due to concurrent Graves' disease [10].…”

Section: Introductionmentioning

confidence: 99%

“…Subtle eye signs are not uncommon in HT, when actively sought being found in up to a third of cases [5]. Florid TED however is unusual with HT, with only 5 prior cases reported [6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Sight Threatening Thyroid Eye Disease Complicating Hashimoto’s Thyroiditis

Young¹,

Depczynski²,

Wall³

et al. 2017

Endocrinol Metab Syndr

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A case of sight threatening thyroid eye disease (TED), arising in a 55 year old woman with primary hypothyroidism due to Hashimoto's thyroiditis (HT), is described. TSH receptor antibody (TSHRab) was positive as were orbital antibodies. Initial management consisted of methylprednisone intravenously followed by prednisone orally in a tapering dose, orbital irradiation and decompressive surgery. Visual acuity improved but 9 months later, there was evidence of relapse with features of compressive optic neuropathy, and exophthalmos had worsened. Prednisone dose was increased. At that time, TSHRab was negative. She underwent total thyroidectomy on the understanding that this was experimental therapy, surgery confirmed that thyroid pathology was solely TH without any evidence of Graves' disease. Prednisone was successively tapered without further relapse. Rehabilitative ocular muscle surgery is planned. Whether the improvement seen in TED can be attributed to effect of removal of thyroid antigens following thyroidectomy is purely speculative. Our case illustrates that relapsing sight threatening TED is part of spectrum of TED in HT and demonstrates that clinical features can be severe.

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Severe thyroid-associated orbitopathy in Hashimoto's thyroiditis. Report of 2 cases

Cited by 37 publications

References 27 publications

Prevalence, Phenotype, and Psychosocial Well-Being in Euthyroid/Hypothyroid Thyroid-Associated Orbitopathy

Prevalence, Phenotype, and Psychosocial Well-Being in Euthyroid/Hypothyroid Thyroid-Associated Orbitopathy

Idiopathic Orbital Myositis Associated with Graves' Disease

Sight Threatening Thyroid Eye Disease Complicating Hashimoto’s Thyroiditis

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