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An Interesting Case of Euthyroid Graves’ Ophthalmopathy, With Negative Thyroid-Stimulating Hormone Receptor Antibodies
Thyroid eye disease (TED), also known as Graves' orbitopathy or ophthalmopathy (GO) or Graves' eye disease, is an autoimmune condition of the retroocular tissues associated with Graves’ disease. In isolated GO, the patient can present without thyroid hormone dysfunction or systemic symptom...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8608036/ https://www.ncbi.nlm.nih.gov/pubmed/34853745 http://dx.doi.org/10.7759/cureus.19015 |
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author | Moeen, Zunera Aliuddin, Ammar M Gray Wlazlo, Taylor Majid, Hira Kolli, Swapna |
author_facet | Moeen, Zunera Aliuddin, Ammar M Gray Wlazlo, Taylor Majid, Hira Kolli, Swapna |
author_sort | Moeen, Zunera |
collection | PubMed |
description | Thyroid eye disease (TED), also known as Graves' orbitopathy or ophthalmopathy (GO) or Graves' eye disease, is an autoimmune condition of the retroocular tissues associated with Graves’ disease. In isolated GO, the patient can present without thyroid hormone dysfunction or systemic symptoms of Graves’ disease, in which case it is called euthyroid Graves’ ophthalmopathy (EGO). It is very rare for this condition to have negative thyroid-stimulating hormone receptor (TSHR) autoantibodies, and we present such a rare case of a young female, who had progressive bilateral vision loss, intermittent left-sided retroocular headache, and severe bilateral proptosis. The patient was diagnosed with EGO based on multidisciplinary consults, diagnostic orbital magnetic resonance imaging (MRI) results, and a good response to treatment with intravenous steroids. Later, the patient was followed as an outpatient and treated with thyroid orbitopathy-specific immunotherapy with teprotumumab. The patient’s response to teprotumumab was excellent and caused significant improvement in visual acuity, proptosis, and chemosis. This adds valuable literature to the medical field and gives insight to clinicians to consider the diagnosis of GO even with seronegative TSHR autoantibodies and euthyroid hormone status. It also adds to the understanding of the complex pathophysiology of this rare condition. |
format | Online Article Text |
id | pubmed-8608036 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-86080362021-11-30 An Interesting Case of Euthyroid Graves’ Ophthalmopathy, With Negative Thyroid-Stimulating Hormone Receptor Antibodies Moeen, Zunera Aliuddin, Ammar M Gray Wlazlo, Taylor Majid, Hira Kolli, Swapna Cureus Endocrinology/Diabetes/Metabolism Thyroid eye disease (TED), also known as Graves' orbitopathy or ophthalmopathy (GO) or Graves' eye disease, is an autoimmune condition of the retroocular tissues associated with Graves’ disease. In isolated GO, the patient can present without thyroid hormone dysfunction or systemic symptoms of Graves’ disease, in which case it is called euthyroid Graves’ ophthalmopathy (EGO). It is very rare for this condition to have negative thyroid-stimulating hormone receptor (TSHR) autoantibodies, and we present such a rare case of a young female, who had progressive bilateral vision loss, intermittent left-sided retroocular headache, and severe bilateral proptosis. The patient was diagnosed with EGO based on multidisciplinary consults, diagnostic orbital magnetic resonance imaging (MRI) results, and a good response to treatment with intravenous steroids. Later, the patient was followed as an outpatient and treated with thyroid orbitopathy-specific immunotherapy with teprotumumab. The patient’s response to teprotumumab was excellent and caused significant improvement in visual acuity, proptosis, and chemosis. This adds valuable literature to the medical field and gives insight to clinicians to consider the diagnosis of GO even with seronegative TSHR autoantibodies and euthyroid hormone status. It also adds to the understanding of the complex pathophysiology of this rare condition. Cureus 2021-10-24 /pmc/articles/PMC8608036/ /pubmed/34853745 http://dx.doi.org/10.7759/cureus.19015 Text en Copyright © 2021, Moeen et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Endocrinology/Diabetes/Metabolism Moeen, Zunera Aliuddin, Ammar M Gray Wlazlo, Taylor Majid, Hira Kolli, Swapna An Interesting Case of Euthyroid Graves’ Ophthalmopathy, With Negative Thyroid-Stimulating Hormone Receptor Antibodies |
title | An Interesting Case of Euthyroid Graves’ Ophthalmopathy, With Negative Thyroid-Stimulating Hormone Receptor Antibodies |
title_full | An Interesting Case of Euthyroid Graves’ Ophthalmopathy, With Negative Thyroid-Stimulating Hormone Receptor Antibodies |
title_fullStr | An Interesting Case of Euthyroid Graves’ Ophthalmopathy, With Negative Thyroid-Stimulating Hormone Receptor Antibodies |
title_full_unstemmed | An Interesting Case of Euthyroid Graves’ Ophthalmopathy, With Negative Thyroid-Stimulating Hormone Receptor Antibodies |
title_short | An Interesting Case of Euthyroid Graves’ Ophthalmopathy, With Negative Thyroid-Stimulating Hormone Receptor Antibodies |
title_sort | interesting case of euthyroid graves’ ophthalmopathy, with negative thyroid-stimulating hormone receptor antibodies |
topic | Endocrinology/Diabetes/Metabolism |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8608036/ https://www.ncbi.nlm.nih.gov/pubmed/34853745 http://dx.doi.org/10.7759/cureus.19015 |
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