Endocrine Abstracts

Objectives: A sporadic association between thyroid and non-organ-specific autoimmunity has been reported, which could be relevant for Graves’ orbitopathy (GO), an autoimmune disease affecting orbital connective tissue. We investigated whether there is an association between GO and anti-nuclear antibodies (ANAs).Methods: We performed a cross-sectional investigation in 265 consecutive patients with Graves’ disease (GD) who came to our observation...

Objectives: A role of IgG4 in Graves’ disease (GD) has been proposed, although the available data are conflicting. In addition, an association between Graves’ orbitopathy (GO) and IgG4-related disease has been postulated, but no firm demonstration has been obtained. Thus, the aim of the present study was to investigate the role of IgG4 in GD.Methods: We performed a cross-sectional investigation in 351 consecutive patients (F=284, M=67; age 48.2...

Whether TTA affects GO remains to be established. Here we studied the effects of TTA in 90 patients with mild-moderate GO randomized into 3 groups of thyroid treatment: MMI (methimazole), TX [near-total thyroidectomy (NTTX)], TTA (NTTX plus 131-I). Patients were treated with ivGC and evaluated at 3 and 9 mo. GO was considered improved or worsened when at least 2 of the following criteria changed, either positively or negatively: i) proptosis and/or eyelid width by at least 2 m...

Background: Sirolimus is an immunosuppressive drug with anti-fibrotic and anti-proliferative activities. In vitro, sirolimus inhibits differentiation of orbital fibroblasts from patients with Graves’ orbitopathy (GO), suggesting a possible use in clinical practice.Methods: We performed a retrospective investigation aimed at evaluating the effects of sirolimus as a second-line treatment for moderate-to-severe, active GO, compared with methyl...

Recently, we have reported a few cases of acute liver damage in patients with Graves’ ophthalmopathy (GO), during or following high dose intravenous (iv) glucocorticoid (GC) pulse therapy. In the present study we analyzed retrospectively liver enzymes (LE) in 294 consecutive patients with GO who underwent ivGC. LE were measured before or during ivGC, and in 91 patients also within 6 months after ivGC. An asymptomatic increase in LE (AST peak: 67–88 U/L, ALT peak: 75&...

RAP (LDL receptor associated protein) is a 44 kDa endoplasmic reticulum (ER) resident molecular chaperone. In the thyroid RAP is required for expression of megalin, an endocytic receptor responsible for transcytosis of thyroglobulin (Tg), but it also binds to Tg itself, suggesting it may affect thyroid function in various manners. Indeed, findings in RAP KO mice indicate that disruption of the RAP gene results in impaired Tg storage into the colloid, suggesting that RAP serves...

Objectives: Optimal treatment for Graves’ hyperthyroidism (GH) in patients with moderate-to-severe, active Graves’ orbitopathy (GO) remains to be established. There is debate on whether a conservative (antithyroid drugs, ATDs) or an ablative approach (radioactive iodine, RAI, or surgery, Tx)has to be preferred. The aim of the present study was to investigate whether these different approachesresult in a different outcome of GOfollowing intravenous glucocorticoids (iv...

Objectives: Sirolimus is an immunosuppressive drug with anti-fibrotic and anti-proliferative activities. In a recent study, sirolimus (given off-label as a second-line treatment) was found to be associated with a better outcome of Graves’ orbitopathy (GO) at 6 months compared to the standard treatment (intravenous glucocorticoids). Here we investigated the effects of sirolimus over a longer period of time.Methods: The study design entailed data anal...