Basedowian Orbitopathy Without Thyreotoxicosis : A Case Report from Sikasso Hospital
Basedowian Orbitopathy Without Thyreotoxicosis : A Case Report from Sikasso Hospital作者机构:Regional Hospital of Sikasso Sikasso Mali Alliance for the Development of Community Ophthalmology (ADOC) Bamako Mali Referral Health Center for Commune 3 in the District of Bamako Bamako Mali African Tropical Ophthalmology Institute Bamako Mali Referral Health Center for Commune 4 in the District of Bamako Bamako Mali
出 版 物:《Open Journal of Ophthalmology》 (眼科学期刊(英文))
年 卷 期:2023年第13卷第3期
页 面:273-279页
学科分类:1002[医学-临床医学] 100201[医学-内科学(含:心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学]
主 题:Euthyroidism Basedowian Orbitopathy Orbital-Cerebral MRI Corticoster-oid Therapy
摘 要:Basedowian orbitopathy is an autoimmune disease representing the most frequent extra-thyroidal manifestation. Its pathophysiology is imperfectly elucidated and is the result of cross-reactivity between thyroid antigens and orbital tissue. It is most frequently seen in the context of hyperthyroidism (basedow’s disease or Graves’ disease), sometimes hypothyroidism (Hashimoto’s thyroiditis), or euthyroidism. Diagnosis is often straightforward, but management remains difficult. The introduction of simple medical treatment exposes the patient to the risk of recurrence. In Sikasso, there have been few studies of Graves’ disease. The aim of this study was to describe the clinical, therapeutic and evolutionary features of Graves’ disease in Sikasso Hospital. The patient was a 35-year-old woman with no previous history of Graves’ disease and no history of alcohol or tobacco intoxication, consulting for bilateral exophthalmos with moderate pain for 1 year. Endocrine tests were normal (euthyroidism), as was orbital-cerebral MRI, which revealed stage II exophthalmos with no sellar or supra-saltar abnormalities. The main complication was exposure to keratitis. Our patient was treated with corticosteroids. The evolution was favorable under treatment, with no recurrence after one year’s follow-up. Graves’ disease is the most common cause of hyperthyroidism, but this should not obscure the diagnosis of euthyroidism, as demonstrated in this case report. Exophthalmos remains the main ophthalmological clinical manifestation.