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Case Reports
. 2013 Mar;17(2):344-8.
doi: 10.4103/2230-8210.109669.

Rituximab therapy in steroid-resistant severe hypothyroid Grave's ophthalmopathy

Aditi Pandit  1 , Abhay Gundgurthi, Sandeep Kharb, Karninder S Brar, M K Garg
Affiliations
Case Reports

Rituximab therapy in steroid-resistant severe hypothyroid Grave's ophthalmopathy

Aditi Pandit et al. Indian J Endocrinol Metab. 2013 Mar.

Abstract

Association of Grave's ophthalmopathy with hyperthyroidism is well known, and it has also been reported in euthyroid or hypothyroid autoimmune thyroiditis, which rarely requires treatment. Here, we report a case of bilaterally symmetrical severe corticosteroid-resistant hypothyroid Grave's ophthalmopathy successfully treated with rituximab.

Keywords: Grave's ophthalmopathy; hypothyroid ophthalmopathy; rituximab.

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Conflict of interest statement

Conflict of Interest: No

Figures

Figure 1
Figure 1
(a) Eye signs in pre-steroid stage. (b) Minimal change post-steroid. (c) Regression of eye signs following rituximab therapy
Figure 2
Figure 2
(a and b) MRI orbit showing symmetrically diffuse increased bulk of extraocular muscles with increased signal intensity in pre-steroid stage. (c and d) Minimal change post-steroid with compression at the orbital apex due to crowding
See this image and copyright information in PMC

References

    1. Burch H, Wartofsky L. Grave's ophthalmopathy: Current concepts regarding pathogenesis and management. Endocr Rev. 1993;14:747–93. - PubMed
    1. Bartelena L, Tanda ML. Grave's ophthalmopathy. N Engl J Med. 2009;360:994–1001. - PubMed
    1. Eckstein AK, Losch C, Glowacka D, Schott M, Mann K, Esser J, et al. Euthyroid and primarily hypothyroid patients develop milder and significantly more asymmetrical Grave's Ophthalmopathy. Br J Ophthalmol. 2009;93:1052–6. - PubMed
    1. Lahooti H, Parmar KR, Wall JR. Pathogenesis of thyroid-associated ophthalmopathy: Does autoimmunity against calsequestrin and collagen XIII play a role? Clin Ophthalmol. 2010;4:417–25. - PMC - PubMed
    1. Douglas RS, Naik V, Hwang CJ, Afifiyan NF, Gianoukakis AG, Sand D, et al. B cells from patients with Graves’ disease aberrantly express the IGF-1 receptor: Implications for disease pathogenesis. J Immunol. 2008;181:5768–74. - PMC - PubMed

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