Endocrine Abstracts

Pretibial myxedema (PM) is a rare extrathyroidal manifestation of Graves’ disease for which there is no specific treatment. When the clinical picture is markedly evident, topical treatment with steroid ointments is practised. There has been previous experience of subcutaneous injections with steroids by using standard needles, but this procedure caused nodular degeneration of the skin. Aim of the present study was to experiment a novel modality of treatment with the injec...

Dysthyroid optic neuropathy (DON) is a sight threatening complication occurring in 3–5% patients with Graves’ orbitopathy. The medical treatment consists in the infusion of high dose of methylprednisolone (MP), while surgical orbital decompression is mandatory in patients non responding to the medical treatment. We aimed at studying the response to high dose steroids in DON and parameters for predicting therapy effectiveness. Twenty-three patients with DON were studi...

We have retrospectively studied the clinical outcome of 58 patients (14 men and 44 women) with autoimmune thyroid disease and active GO, treated with high dose intravenous methylprednisolone (MP; cumulative dose 7.5 g). Ophthalmological assessment was performed at baseline and at 6, 12 and 24–30 weeks after the first MP infusion. In 43/58 patients we have also studied NR3C1gene polymorphism, which has been associated to different sensitivity to steroids. The therapeutic o...

In assessing TAO, orbital CT scan allows measurement of extraocular muscle and optic nerve dimensions but it is useful mainly for a qualitative analysis and cannot be used in the clinical score of the disease. Aim of the present study was to seek a number which could express the expansion of the orbital tissue and be used in grading the severity of TAO. 39 TAO patients and 24 control subjects were studied. We have measured the orbital area (OA) on the central axial section of ...

We are conducting an open study on the treatment of Graves’ disease (GD) and thyroid-associated ophthalmopathy (TAO) with the monoclonal antibody to CD-20, rituximab (RTX) (MabThera, Hoffman-Roche, Basel). RTX induces depletion of B cells and GD is typically a B cell dependent autoimmune disease. We present preliminary results on 7 patients with GD and TAO at different clinical stages: 3 women with newly diagnosed GD and initial TAO; 1 woman with GD and moderate-severe TA...

BAFF, a member of the TNF family, promotes autoantibody production by increasing B cell survival and proliferation. We have previously shown that serum BAFF concentrations are increased in GD patients. In the present work, we studied the expression of BAFF and BAFF-R, by immunohistochemistry (IHC) on paraffin embedded sections of: 1. orbital adipose tissue from 22 patients (5 men, 17 women) with GO (3 of them with active GO) associated with GD or Hashimoto thyroiditis in 19 an...