| Severe thyroid-associated orbitopathy in Hashimoto's thyroiditis. Report of 2 cases. | |
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MedLine Citation:
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PMID: 21427503 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Thyroid-associated orbitopathy (TAO) is characterized by immune-mediated inflammation of the extraocular muscles surrounding orbital connective tissue and adipose tissue. Severe orbitopathy related to autoimmune thyroid disease often occurs in patients with Grave's disease, but it is rare in patients with Hashimoto's thyroiditis. The pathogenesis of TAO is unclear. Several studies have noted a strong correlation between the levels of antibodies to thyrotropin receptor antibody (TRAb) and TAO in Graves' disease. Mild upper eyelid retraction has been reported to be common in Hashimoto's thyroiditis patients, however severe orbitopathy is rare. We report two cases of severe TAO in patients with Hashimoto's thyroiditis who required systemic glucocorticoid therapy and orbital irradiation to treat the TAO. The activity of the TAO was high in both patients, because their clinical activity scores (CAS) for the orbitopathy were high, and magnetic resonance imaging (MRI) showed enlargement of the extraocular muscles and an increase in T2 signal intensity and prolonged T2 relaxation time which indicate an active stage of inflammation. We tested the presence of TRAb by three different assays and were negative in both patients. Since the eye muscle damage cannot be due to TSH receptor antibodies, other pathogenetic mechanisms may be responsible for the orbitopathy in patients with Hashimoto's thyroiditis. |
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Authors:
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Ai Yoshihara; Jaeduk Yoshimura Noh; Ayako Nakachi; Hidemi Ohye; Shiori Sato; Kenichi Sekiya; Yuka Kosuga; Miho Suzuki; Masako Matsumoto; Yo Kunii; Natsuko Watanabe; Koji Mukasa; Yoichi Inoue; Kunihiko Ito; Koichi Ito |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-3-17 |
Journal Detail:
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Title: Endocrine journal Volume: - ISSN: 1348-4540 ISO Abbreviation: - Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-3-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9313485 Medline TA: Endocr J Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Ito Hospital, Tokyo, Japan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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