Graves' ophthalmopathy: From pathogenesis to management
Journal
Journal of Internal Medicine of Taiwan
Journal Volume
24
Journal Issue
4
Pages
258-264
Date Issued
2013
Author(s)
Abstract
Hyperthyroidism, Graves' ophthalmopathy and pretibial myxedema are three major manifestations of Graves' disease. TSH receptor antibody stimulates TSH receptors on the follicular cells of the thyroid to over produce thyroid hormones, resulting hyperthyroidism. However, the etiology of Graves' ophthalmopathy and pretibial myxedema is not so clear. It is quite clear that Graves' ophthalmopathy is an autoimmune disease. It may be related to the action of T cells with TSH receptors on retrobulbar fibroblasts and adipocytes, and T cells produce cytokines to stimulate fibroblasts to secrete glycosaminoglycans which absorb water to make swelling of extraocular muscles and retrobulbar tissues. Orbital computed tomography is an important method to examine Graves' ophthalmopathy. In addition, the activity of Graves' ophthalmopathy should be evaluated. If it is in active stage, high dose of corticosteroid could be used. If it is inactive, but still symptomatic, surgery may be necessary. The patient should be kept in euthyroid state at any stage. In conclusion, the management of Graves' ophthalmopathy should be managed by team work to get the best result.
Subjects
Computed tomography; Glycosaminoglycan; Graves' disease; Graves' ophthalmopathy
SDGs
Other Subjects
corticosteroid; glycosaminoglycan; thyrotropin receptor; adipocyte; article; computer assisted tomography; corticosteroid therapy; cytokine production; drug megadose; endocrine ophthalmopathy; euthyroidism; extraocular muscle; fibroblast; human; pathogenesis; swelling; T lymphocyte; water absorption
Type
journal article