| The role of intravenous methylprednisolone immunosuppression in the management of active thyroid eye disease. | |
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MedLine Citation:
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PMID: 20812826 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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PURPOSE: To analyze the efficacy of intravenous methylprednisolone (IVMP) immunosuppression in the management of active thyroid eye disease (TED). METHODS: This is a consecutive case series of 36 patients treated with 1 g of IVMP over 3 days, between January 2000 and January 2008. The indications for this treatment were moderate to severe active TED with or without optic nerve compression. RESULTS: There were 32 hyperthyroid, 2 hypothyroid, and 2 euthyroid patients in this series. Nine patients presented with optic nerve compromise, 3 had severe active TED and 24 had moderately active TED. Twenty-seven patients received one course of IVMP and nine patients received two courses. All patients had tapering oral prednisolone over 1 month following the IVMP. The mean improvement in proptosis was 1.31 mm (range = 0-3 mm). Optic nerve function improved in seven of nine patients (77.8%). Extra ocular muscle movement improved in 18 patients (50%). Overall benefit from IVMP was seen at 1/12 in 27 patients (75%) and at 3/12 in 30 patients (83%). After IVMP one patient underwent radiotherapy and three patients had nonsteroidal immunosuppression. CONCLUSIONS: IVMP immunosuppression is effective in 83% of patients. The effect lasts from 3 months to 8 years, with a mean of 15 months in 30.5%. It remains a useful modality of treatment especially when the optic nerve or cornea is threatened because of moderate to severe active TED. We encountered no severe side effects of pulsed IVMP and 3 g over 3 days is a safe dose. |
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Authors:
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Katya Tambe; Jonathan Bhargava; Ajay Tripathi; Marelena Gregory; Joyce Burns; Raghavan Sampath |
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Publication Detail:
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Type: Journal Article Date: 2010-09-02 |
Journal Detail:
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Title: Orbit (Amsterdam, Netherlands) Volume: 29 ISSN: 1744-5108 ISO Abbreviation: Orbit Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8301221 Medline TA: Orbit Country: England |
Other Details:
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Languages: eng Pagination: 227-31 Citation Subset: IM |
Affiliation:
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Lid, Lacrimal and Orbit Service, Department of Ophthalmology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester LE1 5WW, UK. katya.tambe@gmail.com |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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