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Changing the Face of Thyroid Eye Disease
source: Eye
year: 2022
authors: Shoaib Ugradar, Robert A. Goldberg, Raymond S. Douglas
summary/abstract:The history of medicine often shows us that a novel idea is not as novel as it may first appear. This is the case with thyroid-associated orbitopathy (TAO). It was first described between 1040 and 1136 AD as a systemic disorder relating enlargement of the thyroid gland to exophthalmos. This concept of a systemic condition causing exophthalmos was later readdressed in greater detail by Parry (1786) and Graves (1835). The condition is named after the latter.
Over the years, our understanding of Graves’ disease (GD) has increased. We now know that it is the most common cause of hyperthyroidism and is responsible for a myriad of signs including; a goiter, a resting tremor, tachycardia, hyperreflexia, lid lag, skin changes, and proximal myopathy. Thyroid dermopathy (pretibial myxoedema), nodular or diffuse thickening of the pretibial skin is found in 13% of patients with GD. Further, 20% of patients with dermopathy present with clubbing of the fingers and toes (thyroid acropachy). The most common extrathyroidal manifestation of GD is TAO, presenting in up to 50% of patients. It is characterized by proptosis, chemosis, diplopia and in severe cases, loss of vision.
organization: University of California, USA; Cedars-Sinai Medical Center, USADOI: 10.1038/s41433-022-02186-0
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