Endocrine Abstracts

Since our first report on successful treatment of one patient with moderate-severe GO in 2006, several non-controlled studies have suggested that RTX can be more effective in active GO than intravenous methylprednisolone (ivMP). One randomised controlled trial comparing RTX to placebo and one comparing RTX to steroids in moderate-severe GO were recently published.We have randomised 32 patients with active moderate-severe GO to be treated with RTX or ivMP...

There is preliminary evidence that B cell depletion with rituximab (RTX), a chimeric mouse-human monoclonal antibody directed against the CD 20 antigen on B lymphocytes, may be effective for the treatment of moderate-severe Graves’ orbitopathy (GO). While mostly non-controlled studies have shown that this modality of immunosuppression has potential in the therapy of moderate–severe GO, in particular for the control of the active, inflammatory phase of the disease. Th...

The role of B-cell in human autoimmune disease have recently been emphasized due to the therapeutic benefit of B-cell depleting therapies. B cells are involved in the production of autoantibodies, CD4+T-cell activation and control of T-cell function and inflammation, through cytokine production. Although autoantibodies alone may not initiate autoimmune disease, their relationship with the disease course suggests that they are a key factor contributing to the mechanisms of dise...

IntroductionMedical immunosuppressive treatment of Graves’ orbitopathy (GO) is advised for patents with moderate-severe disease. Steroids represent the mainstay of therapy, as they possess anti-inflammatory activity, but about 20 – 30% of patients are unresponsive and up to 20% of patients may relapse. Immunosuppressive therapeutics alternative to corticosteroids are those targeting the different antigens involved in the pathogenic reactions of...

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic disease (Covid-19) has caused millions of deaths worldwide, thus a massive SARS-CoV-2 vaccination campaign has been launched since the end of 2020. Viruses and vaccines can induce adverse thyroid effects; SARS-CoV-2 infection and vaccines have been associated with several thyroid disorders, especially subacute thyroiditis (SAT) and Graves’ disease (GD). We aimed to study the occurrence o...

The anti-CD 20 antibody rituximab (RTX) has been employed in the treatment of several autoimmune diseases and its effect may not involve autoantibody secretion. Preliminary studies have shown that RTX induced improvement of active Graves’ orbitopathy (GO) but caused no change of serum anti-thyroid antibodies in relation to peripheral CD 20+ cells depletion, usually observed at the second week after therapy. A 50-year-old woman with GO predominantly active in the left eye ...

A seasonal occurrence of Graves’ disease (GD) has been reported in previous studies, with a peak of frequency in the warmer half of the year (Ford 1988, 1991, Westphal 1994) or the period of the year with a higher iodine intake (Phillips 1985); other studies (Facciani 2000) have failed to find a different seasonal occurrence of Graves’ orbitopathy (GO). Aim of the present study was to evaluate a possible seasonal difference in the onset of GD and GO in a series of ou...

Background: The Covid-19 pandemic caused by the severe-acute-respiratory-syndrome-coronavirus-2 (SARS-CoV-2) determined millions of deaths worldwide, thus at the end of 2020 a massive vaccination campaign has been launched. SARS-CoV-2 infection and vaccines have been associated with several thyroid disorders, especially subacute thyroiditis (SAT), Graves’ disease (GD) and orbitopathy (GO). We studied the occurrence of SAT and GO following SARS-CoV-2 infection or vaccinati...

Introduction: The humanized antibody anti-CD52+ alemtuzumab has been approved since 2014 for the treatment of relapsing-remitting multiple sclerosis (RRMS). Immune reconstitution after alemtuzumab induces thyroid autoimmunity in 34-41% of patients with RRMS, with Graves’ disease (GD) accounting for 63-65% of cases. Graves’ Orbitopathy (GO) may also occur in 13% of patients after alemtuzumab and is scarcely reported. Here we present the first case of alemtuzumab-induc...

Aim: The aim of this retrospective study was to assess the efficacy of different doses of rituximab (RTX) in patients with active moderate-severe Graves’ Orbitopathy (GO).Methods: Overall 40 patients, 5 M/35 F; mean age (± S.D.) 58±11 years were treated with RTX; 21 were smokers. The patients received the following treatment: 14 patients (group 1) a single 100 mg dose; 15 patients (group 2) a single 500 mg dose and 11 Patien...