Anti-eye muscle antibodies and hypothyroid Graves' disease: a case report.

Publisher: Jikei University School Of Medicine Department Of Anatomy Country of Publication: Japan NLM ID: 0376546 Publication Model: Print Cited Medium: Print ISSN: 0013-7219 (Print) Linking ISSN: 00137219 NLM ISO Abbreviation: Endocrinol Jpn Subsets: MEDLINE

Publication: Tokyo : Jikei University School Of Medicine Department Of Anatomy
Original Publication: Tokyo, Endocrinological Society of Japan, Eastern Branch.

Autoantibodies/*blood ; Eye Diseases/*etiology ; Graves Disease/*immunology ; Hypothyroidism/*immunology ; Oculomotor Muscles/*immunology; Aged ; Blotting, Western ; Graves Disease/chemically induced ; Graves Disease/complications ; Graves Disease/drug therapy ; Humans ; Hypothyroidism/etiology ; Immunoglobulins, Thyroid-Stimulating ; Lithium/adverse effects ; Magnetic Resonance Imaging ; Male ; Methylprednisolone/therapeutic use ; Oculomotor Muscles/diagnostic imaging ; Oculomotor Muscles/pathology ; Thyroglobulin/blood ; Thyroid Gland/immunology ; Thyroid Gland/physiopathology ; Thyroid Hormones/blood ; Thyroxine/blood ; Thyroxine/therapeutic use ; Tomography, X-Ray Computed

We report the case of a 70-year-old man who developed hypothyroidism associated with TSH receptor antibodies and severe ophthalmopathy during lithium therapy. He had received lithium therapy for more than 20 years for manic depression, when ophthalmopathy (class VI of the American Thyroid Association classification) and mild hypothyroidism developed. Orbital magnetic resonance imaging indicated marked enlargement of the superior, medial and inferior rectus muscles in the left eye. He had anti-eye muscle antibodies in his serum, detected by Western blotting and quantified by chromatoscanning, as well as anti-TSH receptor antibodies. He was treated with supplementation of levothyroxine and four cycles of methylprednisolone pulse therapy. After the pulse therapy, both anti-eye muscle antibodies and anti-TSH receptor antibodies decreased and disappeared in parallel with the improvement in eye symptoms and signs. These observations suggest the importance of anti-eye muscle antibodies as clinical markers in the development of thyroid-associated ophthalmopathy.

0 (Autoantibodies)
0 (Immunoglobulins, Thyroid-Stimulating)
0 (Thyroid Hormones)
9010-34-8 (Thyroglobulin)
9FN79X2M3F (Lithium)
Q51BO43MG4 (Thyroxine)
X4W7ZR7023 (Methylprednisolone)

Date Created: 19921201 Date Completed: 19930415 Latest Revision: 20190827

20231215

10.1507/endocrj1954.39.593

1363467