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Iv steroids for Graves' ophthalmopathy side effects

Immunosuppressive treatment of Graves' ophthalmopathy. Future developments in immunosuppression aim at reduction of side effects and enhancement of efficacy. Alternative treatment schedules (e.g., methylprednisolone pulses, intravenous immunoglobulin) may have equal efficacy but less side effects than classic high-dose oral steroids. Question I have a question regarding standard protocols for IV glucocorticoid therapy for Graves ophthalmopathy w/ constant diplopia. Is there a best practices protocol now established? I've just completed pulse IV therapy of 3 days, every other day, 1000 mg Solumedrol each session. I'm wondering if this is typically repeated, is followed by oral prednisone, [

Treatment of moderate to severe Graves' orbitopathy (GO) is based mainly on intravenous pulses of methylprednisolone. High doses of methylprednisolone can exert several adverse effects, some of which might be life-threatening. The objective of this study is to describe the most severe complications associated with intravenous administration of high doses of glucocorticoids, and to develop. Improvements observed after treatment have been stable in both groups. In conclusion, in addition to a lower incidence of side-effects compared to the classic oral therapy, the high-dose iv steroid therapy provides efficient and stable improvement in Graves' ophthalmopathy. Major Subject Heading (s) Minor Subject Heading (s Intravenous steroids are more effective and have a lower side effects burden than oral steroids and, thus, are the preferred mode of administration. Successful treatment outcome has been demonstrated in 83% of patients treated with 500 mg methylprednisolone for 4 cycles at 4 weekly intervals compared with 11% of patients receiving placebo ( P. Treatment with iv glucocorticoids was safe and effective (response rate, 82.6%) and was associated with both a lower recurrence rate and less frequent side effects compared with oral regimens. In patients with active and severe GO, enlarged eye muscles significantly reduced in size after iv treatment (40) Relevant side-effects were reported from patients receiving oral therapy, but no significant side-effects were observed in patients treated with high iv doses; a few cases presented with gastric..

Immunosuppressive treatment of Graves' ophthalmopathy

  1. It may cause ocular symptoms including periorbital edema, chemosis, eyelid retraction, proptosis, altered ocular motility, and even diplopia, exposure keratopathy, and dysthyroid optic neuropathy (DON), which may result in visual loss. The prevalence rate of GO ranges from 0.1% to 0.3% [
  2. istered dose and therapy schedule has not been assessed yet. Subjects and methods: Nine randomized and 14 non-randomized controlled trials of IV steroids in GO were evaluated according to the applied single and cumulative doses with respect to.
  3. Abstract. To evaluate the efficacy of high-dose intravenous steroid pulse followed by oral steroids in the treatment of thyroid-associated ophthalmopathy, we performed clinical assessment and measurement of retroorbital muscle enlargement in 27 patients before and after the therapy, and followed them up longitudinally
  4. To elucidate the therapeutic responses to corticosteroids and prognostic factors in the treatment of Graves' ophthalmopathy, 23 patients with Graves' ophthalmopathy were treated with intravenous.
  5. ium oxide or ranitidine), while most of the patients referred to cutaneous rashes and a metal taste that disappeared some hours after the infusion
  6. Side effects are infrequent and include transient worsening of conjunctival irritation and/or edema and loss of eyebrows [ 4,6 ]. Results appear in about 2 to 3 weeks, with maximal effects seen at 6 to 12 months [ 3,6,10 ]. The risk of radiation retinopathy warrants the annual evaluation of patients submitted to orbital radiation [ 7 ]

Steroids in Graves' Eye Disease - Thyroid Disease

  1. In order to compare oral and high-dose iv corticosteroid therapy for Graves' disease, 25 patients with Graves' ophthalmopathy were treated with two weekly iv injections of 1g of methylprednisolone diluted in 250-500 ml of physiological solution for 6 weeks, and were compared to a group of 26 patients treated with oral prednisone at a dose of 60-80 mg/day progressively reduced every 2 weeks for.
  2. Intravenous (IV) corticosteroids used in repeated weekly pulses were more effective (overall favorable response = 74.6 %, n = 177) and had fewer side effects than daily oral corticosteroids (overall favorable response = 55.5 %, n = 265). A combination of corticosteroid and radiation therapy seemed to be more effective than corticosteroids alone
  3. The frequency of side effects was higher in patients treated with oral steroids vs. IV steroids (82% vs. 39%). However, there were more deaths in patients that were treated with IV steroids, as a total of 7 patients died: 4 of liver failure, 2 of stroke and 1 of pulmonary embolism

Life-threatening complications of high doses of

Purpose: Graves' ophthalmopathy (GO) is an autoimmune condition primarily managed with prolonged courses of glucocorticoids, which can be associated with significant side effects. Orbital radiation therapy (RT) is an alternative treatment that has shown variable efficacy in improving orbital and visual symptoms Graves' eye disease, also called Graves' ophthalmopathy, is a problem that develops in people with an overactive thyroid caused by Graves' disease. Up to one-half of people with Graves' disease develop eye symptoms. High dose prednisone or an intravenous corticosteroid is used if there is compression of the optic nerve. This is the most.

Moreover, patients treated with IVGC reported less frequent side effects like dyspepsia, insomnia, anxiety, hyperglycemia, and Cushingoid features. The 10 patients who developed active GO of moderate severity (three from group A and seven from group B), despite prophylactic OGC, were subsequently treated with a full course of IVGC The therapeutic outcome of intravenous steroid therapy for active Graves' orbitopathy is influenced by the time of response but not polymorphisms of the glucocorticoid receptor By Mario Salvi Intravenous glucocorticoid therapy for Graves' ophthalmopathy and acute liver damage: an epidemiological stud Thyroid eye disease (TED) is an inflammatory disease of the eye and the surrounding tissues. The inflammation is due to an autoimmune reaction - the body's immune system is attacking tissues within and around the eye socket. TED is sometimes referred to by other names, such as Graves' ophthalmopathy, Graves' orbitopathy, thyroid-associated ophthalmopathy, and/or thyroid orbitopathy Steroid Laws In Thailand Steroid Shots Back Pain Side Effects If you have lower back pain, you are not alone. About 80 percent of adults experience low back pain at some point in their lifetimes. It is the most common cause of job-related disability and a. 18.06.2018. While most side effects and risks are low for this common procedure Graves' ophthalmopathy is defined as autoimmune inflammation of extraocular muscles and orbital fat or connective tissue, usually in patients with Graves' disease. About one in 20 patients with Graves' hyperthyroidism has moderate-to-severe Graves' ophthalmopathy. Corticosteroids have been the mainstay of treatment, but new evidence about immune mechanisms has provided a basis to explore other.

IV Steroids for the Treatment of Clinically Active and

  1. istration of this type of medication because they are more effective and have fewer side effects. If these measures do not work, it may be necessary to relieve pressure in the orbit by removing part of the tissue either by operation or by treating.
  2. Intravenous (IV) corticosteroids used in repeated weekly pulses were more effective (overall favorable response = 74.6 %, n = 177) and had fewer side effects than daily oral corticosteroids (overall favorable response = 55.5 %, n = 265). A combination of corticosteroid and radiaton ti herapy seemed to be more effective than corticosteroids alone
  3. steroids was higher than 10 grams; accordingly, we now use a lower cumulative dose of iv methylprednisolone (8 grams rather than 12-14 grams) and are satisfied with the lower liver toxicity of this regimen. Table 2. Side effects of intravenous and oral glucocorticoids in 82 patients with severe Graves' ophthalmopathy. Intravenous Oral n = 41.
  4. Active, moderately severe Graves' ophthalmopathy qualifies for immunosuppression: intravenous pulsed methylprednisolone is more efficacious and has fewer side effects than oral steroids

an effective procedure in patients for whom other treatments are inadequate or are associated with significant side effects. In a systematic review and meta-analysis on treatment modalities for Graves' ophthalmopathy, Stiebel-Kalish et al (2009) concluded that current evidence demonstrates the effectiveness of intravenous corticosteroids i Moderate and minor side effects were more frequently noted in steroid-treated patients than in the IVIG group. These data suggest that IVIG is safe and effective in reducing the eye changes in patients with Graves' ophthalmopathy. PMID: 9292946 [PubMed - indexed for MEDLINE Purpose:Aim was to report outcome in 18 patients of moderate to severe thyroid associated orbitopathy (TAO) treated with intravenous steroids. Methods: Eleven males and 7 females with mean age of 52.92 years received methylprednisolone. Examination revealed decreased vision(15), lid inflammation(15), & movement restriction(16). They were hyperthyroid(8), hypothyroid(3), euthyroid(7), & 8 had. In Europe, nearly every patient with a diagnosis of thyroid eye disease receives intravenous infusions of steroid once weekly for 12 weeks. 2 Intravenous steroids have been shown to have a greater efficacy than oral steroids (80 percent vs. 50 percent). While this doesn't cure the disease, it does reduce the clinical severity and improve the patient's quality of life

Corticosteroids • Intravenous , Oral • IV pulses are more effective and has less side effects • IV dose (max 8 grams) : 500 mg weekly for 6 weeks and then 250 mg weekly for 6 weeks • Relapse is common (20%) • Steroid response is evident usually 2-4 weeks later • Moderate to severe TED : 71% respond to IV steroid vs 51% oral with SS. All articles published by MDPI are made immediately available worldwide under an open access license. No special permission is required to reuse all or part of the article published by MDPI, including figures and tables Severe Graves' eye disease is usually associated with poor clinical outcomes and impaired quality of life. Treatment currently is intravenous methylprednisolone, but response is often limited and there are significant side effects to high dose steroids. This study aimed to compare the efficacy and safety of combination therapy of the immunosuppressive medication mycophenolate and.

Intravenous Glucocorticoids for Graves' Orbitopathy

  1. ophthalmopathy. Key words: Intravenous steroid, Pulse therapy, Thyroi d, Ophthalmopathy (Endocrine Journal 43: 689-699,1996) THYROID-associated ophthalmopathy (TAO) is a progressive eye disorder ranging from disfiguring proptosis and diplopia to sight loss and is typical-ly associated with Graves' hyperthyroidism
  2. Purpose . The intravenous glucocorticoid (iv GC) represents the mainstay of therapy for Graves' ophthalmopathy (GO), but uncertainty remains concerning the optimal regimen. Although the European Group on Graves' Orbitopathy (EUGOGO) regimen has been commonly employed, evidence for its superiority to other regimens is still lacking
  3. TREATMENT OF OPHTHALMOPATHY: MEDICAL MANAGEMENT STEROIDS ORAL - Oral prednisilone preffered 60-100 mg used as a single dose In the morning. IV Steroids - Used 1 gm daily dose on 3 times a week. Equally Effective as oral steroids with less side effects Peribulbar injection - Triamcelone acetonate is used. 20 mg is Injected in single dose
  4. High-dose intravenous steroids are the first-line treatment for patients with moderate-to-severe and active Graves' ophthalmopathy (GO). We aimed to investigate the response rate of methylprednisolone (MPD) treatment among Korean patients with active moderate-to-severe GO and to identify predictive factors of treatment response
  5. Treatment with corticosteroids, such as prednisone, may lessen swelling behind your eyeballs. Side effects may include fluid retention, weight gain, elevated blood sugar levels, increased blood pressure and mood swings. Teprotumumab (Tepezza). This medication may be used to treat Graves' ophthalmopathy. It's given through an IV in the arm every.
  6. You get this medication through an IV in your arm every 3 weeks. You take it for eight rounds. It can cause side effects such as nausea, diarrhea, muscle spasms, and higher blood sugar levels
  7. The mainstay of medical management involves intravenous corticosteroids for active moderate-to-severe TED. After accurate understanding of the mechanism and pathophysiology of this disease.

Introduction. Graves' ophthalmopathy (GO) encompasses a constellation of ocular signs and symptoms, including proptosis, motility restriction, eyelid retraction, eyelid lag, lagophthalmos and exposure keratopathy, which is closely linked to autoimmune thyroid disease. 1-3 Less than 5-10% of patients will develop severe expression and require aggressive management. 4, 5 Also, the presence of. Future developments in immunosuppression aim at reduction of side effects and enhancement of efficacy. Alternative treatment schedules (e.g., methylprednisolone pulses, intravenous immunoglobulin) may have equal efficacy but less side effects than classic high-dose oral steroids

Abstract. Aim: To evaluate the efficacy of periocular triamcinolone acetonide for the treatment of thyroid associated ophthalmopathy (TAO), and the presence of ocular or systemic adverse effects. Methods: A multicentre prospective pilot study was performed on patients diagnosed with Graves' ophthalmopathy less than 6 months before entry to the study. . Patients were admitted to the study and. In most patients who develop Graves' ophthalmopathy, the eyes bulge forward or the eyelid retracts to some degree. In patients who respond to prednisone, a short course of intravenous (IV) steroids (methylprednisolone) may provide symptomatic improvement with fewer side effects than oral prednisone; this is referred to as an IV steroid.

Biopsy will remain positive for up to two weeks after the initiation of corticosteroid therapy.21 Intravenous corticosteroids should be used in patients with visual symptoms.21 Immediate therapy. Graves' ophthalmopathy (GO) is an autoimmune condition primarily managed with prolonged courses of glucocorticoids, which can be associated with significant side effects. Orbital radiation therapy (RT) is an alternative treatment that has shown variable efficacy in improving orbital and visual symptoms. In this study, the therapeutic benefit of RT was evaluated in terms of patient's. These are: inhibiting T-cell activation, anti-fibroblast effect and blocking the IGF-1 pathway. In contrast to other immunosuppressive drugs, Sirolimus is associated few side effects at low doses. We are planning a comparative study of conventional treatment (corticosteroids) compared with Sirolimus, regarding clinical outcomes and adverse effects

MINGO was an observer-masked, multicentre, block-randomised, centre-stratified trial done in two centres in Germany and two in Italy. Patients with active moderate-to-severe Graves' orbitopathy were randomly assigned to receive intravenous methylprednisolone (500 mg once per week for 6 weeks followed by 250 mg per week for 6 weeks) either alone or with mycophenolate (one 360 mg tablet twice. The two studies underscore the need for better treatment options for active moderate-to-severe Graves' orbitopathy, or thyroid eye disease, which occurs in 5% to 10% of people with Graves' disease Graves ophthalmopathy, also known as thyroid eye disease (TED), is an autoimmune inflammatory disorder of the orbit and periorbital tissues, characterized by upper eyelid retraction, lid lag, swelling, redness (), conjunctivitis, and bulging eyes (exophthalmos). It occurs most commonly in individuals with Graves' disease, and less commonly in individuals with Hashimoto's thyroiditis, or in. N2 - Steroids have been used in the therapy of the moderate to severe forms of Graves' ophthalmopathy (GO) and other autoimmune diseases as they act only as general immunosuppressants. Previous work has shown that blocking the CD-20 receptor on B lymphocytes has significantly affected the clinical course of GO, by rapidly reducing inflammation. In the treatment of TED, it has been trialed alone or in combination with corticosteroids or orbital radiation. 60 -64 In active, moderate-to-severe TED patients unresponsive to steroids or unable to tolerate steroid-related side effects, two retrospective case series have found that methotrexate at a weekly dose of 7.5 or 10 mg led to a.

Glucocorticoids are usually given for management of Graves' ophthalmopathy (GO), but they may cause side effects. By comparison, intravenous administration of immunoglobulins resulted in clinical improvement and decreased antibody titres in a large number of autoimmune diseases. Therefore, a randomized trial was done, in which 19 patients with active GO were treated with a 20‐week course of. Thyroid Associated Ophthalmopathy is condition affecting the eyes of about 10% of patients with Graves disease. Its combination of protrusion affecting the looks of the patient and pain is often severely affecting the quality of life among these patients To evaluate the efficacy of high-dose intravenous steroid pulse followed by oral steroids in the treatment of thyroid-associated ophthalmopathy, we performed clinical assessment and measurement of retroorbital muscle enlargement in 27 patients before and after the therapy, and followed them up longitudinally.The mean duration of follow up is (mean +/- SD) 29.8 +/- 23.8 months (range 4-92)

Furthermore, weekly intravenous steroid therapy appeared to be associated with a better treatment outcome compared to daily therapy with oral steroid tablets, as described in Randomized, single blind trial of intravenous vs. oral steroid monotherap In Graves' orbitopathy Graves ophthalmopathy (GO) is an inflammatory disorder of the eye occurring in association with autoimmune thyroid disease which can result in adverse visual outcome in few severe cases. The most severe complications include corneal ulcerations, globe subluxation and dystrophic optic neuropathy 07/01/2014 - Graves' ophthalmopathy (GO) is an autoimmune condition primarily managed with prolonged courses of glucocorticoids, which can be associated with significant side effects. 06/01/2014 - For patients with active moderate-to-severe Graves' ophthalmopathy (GO), a course of 4.5 g iv glucocorticoids (GCs) is the recommended therapy

Corticosteroids for Graves' Ophthalmopathy: Systematic

  1. Thyroid eye disease, or Graves' ophthalmopathy, is a potentially vision-threatening autoimmune disease that manifests most commonly in hyperthyroid patients (77 percent), and less frequently in euthyroid (20 percent) and hypothyroid (3 percent) patients. 1 TED can precede or succeed the thyroid disease, usually within 18 months of each other in the majority of the patients. 2 Although great.
  2. Previous steroid use (IV or oral) with a cumulative dose of <1 g methylprednisolone or equivalent for the treatment of TED and previous use of steroid eye drops is allowed if the corticosteroid was discontinued at least 4 weeks prior to inclusion - Corticosteroid use for conditions other than TED within 4 weeks prior to inclusion (topical.
  3. Intravenous (i.v.) glucocorticoid is recommended for active moderate‑to‑severe thyroid‑associated ophthalmopathy (TAO). However, the details of the treatment schedule are still debatable. The present prospective randomized trial was performed to compare clinical outcomes and serum cytokines between the two regimens. A cohort of 90 ;patients with active moderate‑to‑severe TAO was.
  4. We investigated the long-term side-effects of orbital radiotherapy (OR) in 204 patients with Graves' ophthalmopathy (GO), irradiated from 1972-1996 [44 by cobalt unit (CU) and 160 by linear accelerator (LA), mostly combined with glucocorticoids], with a 5- to 25-yr follow-up (median, 11 yr)
  5. Epidemiology. Clinically evident ophthalmopathy occurs in 10% to 25% of unselected patients with Graves' disease if lid signs are excluded as a diagnostic feature, in 30% to 45% if lid signs are included, 3,11 and in approximately 70% of patients without overt eye disease if computed tomography (CT) or increased intraocular pressure on upgaze is used to establish the diagnosis. 12-15.

Dose of intravenous steroids and therapy outcome in Graves

Intravenous corticosteroids used in repeated weekly pulses were more effective (overall favorable response = 74.6%, n = 177) and had fewer side effects than daily oral corticosteroids (overall favorable response = 55.5%, n = 265). A combination of corticosteroid and radiation therapy seemed to be more effective than corticosteroids alone Graves' orbitopathy (GO) is an autoimmune disorder of the orbit, accompanied by a complex of ocular symptoms. It is the most common extrathyroidal manifestation of Graves' disease (GD) and is associated with hyperthyroidism in 90% of cases [].GO primarily involves inflammatory changes in orbital tissues with potential thickening and fibrosis of the extraocular muscles (EOM) and orbital fat. Graves orbitopathy (Graves eye disease or Graves ophthalmopathy) is a constellation of signs and symptoms related to the orbit and surrounding tissues in patients with Graves disease. It can also sporadically occur in patients who are euthyroid or even hypothyroid as a result of chronic thyroiditis. [1] It is an autoimmune process affecting. Condition: Graves Ophthalmopathy; Intervention: Intervention Type: Radiation Intervention Name: External beam radiotherapy Description: 100 Rads to each lateral orbit x 10 doses Arm Group Label: Combined radiotherapy and iv corticosteroid Intervention Type: Drug Intervention Name: intravenous corticosteroids (methylprednisolone) Description: Intravenous methylprednisolone (iv MP) 500 mg weekly.

In moderate to severe GO, the European Group on Graves' Orbitopathy (EUGOGO) recommends a 12-week course of intravenous methylprednisolone (i.v. MP) pulse therapy with a cumulative dose of 4.5 g. The response rate of i.v. GCS treatment is significantly higher than oral glucocorticoid (oral GCS) therapy and is associated with fewer adverse events Intravenous Methylprednisolone Pulses: * Cumulative doses greater than 8 g should be avoided. Side Effects Diabetes Cardiovascular disease Infection susceptibility Hepatotoxicity Major depression Psychosis The eye disease routinely flares upon withdrawal of steroids. There is a 20 to 25% non-responder rate Graves disease is a multisystem autoimmune disease targeting the thyroid, orbit and skin. Clinically detectable thyroid-associated ophthalmopathy (TAO) occurs in approximately 10 to 45 percent of patients with Graves disease 1 with manifestations ranging from mild ocular surface disease to severe proptosis and optic neuropathy. In this article, we will review the current medical treatments.

High-dose intravenous steroid pulse therapy in thyroid

Thyroid associated orbitopathy is a common manifestation of Graves disease. Many options can be considered for treatment. In this case series, we reviewed the medical records of 17 patients who received radiation therapy (RT) for GO in a tertiary care center between 1997 and 2007. All patients received 20 Gy to both orbits and 12 of them (71%) had already received one or more trials of steroid. Background Several immunosuppressive therapeutic regimens are widely used to treat Graves' ophthalmopathy (GO), including oral glucocorticoids (OGC), intravenous glucocorticoids (IVGC), retrobulbar injections of glucocorticoids (ROGC) and orbital radiotherapy (OR). The priority among these is unknown. This meta-analysis investigated the efficacy and tolerability of the above regimens

Intravenous methylprednisolone in the treatment of Graves

Oral or intravenous steroids, according to disease severity, are the most popular treatments. Steroids and orbital radiotherapy, associated as adjuvant therapy, have been shown to be more effective than each one in isolation. Both treatment modalities have shown different side‐effects intervention [2,3,5,6]. Steroids form the first-line of treatment for severe and active TAO. Many studies have documented the effec-tiveness of steroids via oral, intravenous or peribulbar route, but the optimal delivery method with minimal side effects remains in-determinate [4-10]. Although, the intravenous route is considere

Corticosteroids: the most commonly used medical therapy in active moderate-to-severe TED. They alleviate inflammation and the associated symptoms. It is not clear whether they alter the disease course. Studies suggest intravenous steroids are most effective. Complicating factors include the well-known side-effects of systemic steroid therapy Infiltrative ophthalmopathy is a characteristic feature of Graves', clinically apparent in 25 to 50% of these patients (4). While the orbital component of Graves' disease is not completely understood, it is believed to be a multifactorial process with cellular, immunologic and mechanical effects (4) mopathy. European Group on Graves' orbitopathy (EUGOGO) cur-rently recommend IV-GCs as a first-line treatment for active mo-derate to severe GO [11]. A meta-analysis of randomized clinical trials clearly demonstrates that intravenous methylprednisolone shock therapy (IVMP) has higher efficacy and fewer side effects than oral prednisone [12] No severe side effects or relapse of active GO were observed at the end of follow up. CONCLUSIONS: This study suggests that intravenous Tocilizumab may be effective on reducing activity in patients with thyroid eye disease refractory to intravenous steroids T hyroid-associated ophthalmopathy (TAO), also known as thyroid eye disease or Graves' ophthalmopathy, is the most common autoimmune inflammatory disorder of the orbit and periorbital tissue, with approximately three million Americans affected. 1,2 This prevalence is similar to that of glaucoma in the United States. Historically, TAO was limited to patients with Graves' disease and the.

Graves' eye disease, also known as thyroid eye disease, is an autoimmune condition in which immune cells attack the thyroid gland which responds by secreting an excess amount of thyroid hormone. As a result, the thyroid gland enlarges and excess hormones increase metabolism. The hypermetabolic state is characterized by fast pulse/heartbeat. Corticosteroids • Intravenous , Oral • IV pulses are more effective and have less side effects • IV dose (max 8 grams) : 500 mg weekly for 6 weeks and then 250 mg . weekly for 6 weeks • Relapse is common (20%) • Steroid response is evident usually 2-4 weeks later • Moderate to severe TED : 71% respond to IV steroid vs 51% with ora IVIg has less frequent and milder side effects compared to steroids [23, 24]. Birdshot retinochoroidopathy is a similar condition that involves eye inflammation. One study of 18 patients with this disease found that vision improved in half of the people who took IVIg [ 25 ] Clinical and imaging evaluation of the response to intravenous steroids in patients with Graves' orbitopathy and analysis on who requires additional therapy Theodora Tsirouki,1 Alexandra Bargiota,2 Stelios Tigas,3 Agathi Vasileiou,2 Eftichia Kapsalaki,4 Zoe Giotaki,3 Ioannis Asproudis,5 Agathokles Tsatsoulis,3 Georgios Koukoulis,2 Evangelia E Tsironi1 1Department of Ophthalmology, University. GRAVES' DISEASE IS CHARACTERIZED BY HYPERTHYROIDISM, diffuse goitre, ophthalmopathy and, rarely, dermopathy. Although diagnostic testing is straightforward once Graves' disease is suspected, physicians need to be aware of heterogeneous and even atypical presentations of the disease, particularly in elderly patients. Because morbidity may be associated with even subtle forms of hyperthyroidism.

High-Dose Intravenous Pulse Therapy with

Thyroid eye disease (TED) is an autoimmune disease caused by the activation of orbital fibroblasts by autoantibodies directed against thyroid receptors. TED is a rare disease, which had an incidence rate of approximately 19 in 100,000 people per year in one study.[1] The disorder characterized by enlargement of the extraocular muscles, fatty and connective tissue volume The response rate of intravenous steroids is approximately 80%, whereas it is approximately 50% for oral steroids. Intravenous administration of steroids in pulses compared with oral administration is associated with fewer side effects and therefore better tolerability, a lower risk of relapse and a shorter treatment course Kahaly GJ, Pitz S, Hommel G, Dittmar M. Randomized, single blind trial of intravenous versus oral steroid monotherapy in Graves' orbitopathy. J. Clin. Endocrinol. Metab. 90,5234-5240 (2005). Excellent study showing the benefits of intravenous steroid administration

Graves' Ophthalmopathy Treatments - Medical Clinical

Additionally, chronic treatment with steroids can lead to acute liver damage (cytotoxic, autoimmune or viral), liver steatosis and autoimmune hepatitis-related autoantibodies . The advantage of RT over glucocorticosteroids is that it is well tolerated with usually no side effects . The established RT schedule is 20 Gy in 10 daily fractions In conclusion, the side effects of MPPT on bone metabolism were marginal and a second course of MPPT did not worsen bone metabolism. These MPPT regimens may therefore be considered to be a safe and effective treatment option for patients with moderate -to-severe active GO. Introduction Graves' ophthalmopathy (GO), also called thyroid-associate You may report side effects to Health Canada at 1-866-234-2345. Precautions Before using teprotumumab, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies

Vol 5 Issue 6 p.8 American Thyroid Associatio

Graves ophthalmopathy. IVIg may be indicated in select cases. Tagami et al (1996) have shown that IVIg is effective in this condition. Other studies have shown IVIg to be as effective as corticosteroids with fewer side effects. May be indicated where steroids have failed or are contraindicated severe Graves' ophthalmopathy is controversial. Systemic steroids are often effective(1­4), but relapse is common when they are tapered or withdrawn(5). A number of retrospective studies have reported the efficacy of orbital irradiation(6,7) but prospective studies have shown conflicting results(8­10). Some investigators have suggested that. Graves Ophthalmopathy (GO) GO is an inflammatory disorder of the orbit that occurs in association with autoimmune thyroid disease and that affects the muscles and other tissues around the eyes. Initial symptoms may include a dry and gritty ocular sensation, sensitivity to light, excessive tearing, double vision and a sensation of pressure. Thyroid-associated ophthalmopathy (TAO) is common in Graves' disease. However, to date, no standard treatment has been established for TAO. The present study aimed to assess peribulbar injection of corticosteroids for TAO treatment as well as factors affecting therapeutic effectiveness. A retrospective cohort study was performed at West China Hospital, Sichuan University (Chengdu, China) Graves' ophthalmopathy (GO), or thyroid eye disease (TED), is regarded as an autoimmune disorder closely related to Graves's disease (GD). It may cause ocular symptoms including periorbital edema, chemosis, eyelid retraction, proptosis, altered ocular motility, and even diplopia, exposure keratopathy, and dysthyroid optic neuropathy (DON), which may result in visual loss

Bisphosphonates are widely used for various conditions, including osteoporosis, hypercalcemia of malignancy, osteolytic bone metastasis, and Paget's disease. Bisphosphonate-induced orbital inflammation is a rare side effect of amino-bisphosphonates. There has been less focus on the risk of developing amino-bisphosphonate-induced orbitopathy in people who have underlying ophthalmopathy RTX with systemic steroid therapy has been shown to reduce TAO activity and severity over 30 weeks in an open label study. The side effects of RTX reported in studies examining RTX therapy in TAO are of varying prevalence and severity. Few of the patients developed hypotension, febrile illness, sinus tachycardia, and serum sickness To assess the efficacy of intermittent, high-dose treatment with intravenous glucocorticoids (IV GCs) in moderate to severe Graves' ophthalmopathy (GO). Materials and methods Patients with GO treated with IV GCs from August 2007 to August 2011 at the Endocrinology Department of Reina Sofía Hospital were enrolled into the study