Graves' Orbitopathy

Description

The significant progress in the understanding of the pathogenesis and the treatment of Graves’ orbitopathy (GO) has warranted a second edition of this book within three years of the first. Now also fully incorporated is the EUGOGO consensus statement on management of GO, which since has been accepted worldwide as a useful guideline. Furthermore all chapters have been thoroughly updated. Subjects covered include the pathology of GO and the controversial views on its pathogenesis; assessment of changes using reliable measuring techniques; medical management of GO including established and alternative treatment options; technical explanations and illustrations of various surgical procedures and finally, the molecular, immunologic, and clinical aspects of this complex disorder. Two new chapters have been added: one describing the socioeconomic impact of the disease and the other outlining the Amsterdam Declaration on Graves’ Orbitopathy. The successful question-and-answer format facilitates its use as a reference guide for medical practitioners and surgeons working in the fields of ophthalmology, internal medicine, endocrinology, pediatrics, immunology, as well as otorhinolaryngology.

Informations

• Publié par: S. Karger AG
• Date de parution: 17 août 2010
• Nombre de lectures: 0
• EAN13: 9783805595322
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

Graves' Orbitopathy A Multidisciplinary Approach - Questions and Answers
Graves' Orbitopathy
A Multidisciplinary Approach - Questions and Answers
2nd, revised edition
Editors
Wilmar M. Wiersinga Amsterdam
George J. Kahaly Mainz
95 figures, 53 in color, and 41 tables, 2010
_____________________ Wilmar M. Wiersinga, MD, PhD Department of Endocrinology and Metabolism Academic Medical Center University of Amsterdam Meibergdreef 9 NL-1105 AZ Amsterdam (The Netherlands)
_____________________ George J. Kahaly, MD, PhD Department of Medicine I Gutenberg University Medical Center Langenbeckstrasse 1 DE-55131 Mainz (Germany)
Library of Congress Cataloging-in-Publication Data
Graves' orbitopathy: a multidisciplinary approach: questions and answers / editors, Wilmar M. Wiersinga, George J. Kahaly.––2nd, rev. ed.
p.; cm.
Includes bibliographical references and indexes.
ISBN 978-3-8055-9531-5 (soft cover: alk. paper) –– ISBN 978-3-8055-9532-2 (e-ISBN)
1. Thyroid eye disease. I. Wiersinga, Wilmar M. II. Kahaly, George.
[DNLM: 1. Graves Ophthalmopathy-diagnosis. 2. Diagnosis, Differential. 3. Graves Ophthalmopathy-therapy. 4. Ophthalmologic Surgical Procedures. WK 265 G7767 2010]
RE715.T48G75 2010
617.7––dc22
2010021375
Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
© Copyright 2010 by S. Karger AG, P.O. Box, CH-4009 Basel (Switzerland)
www.karger.com
Printed in Switzerland on acid-free and non-aging paper (ISO 9706) by Reinhardt Druck, Basel
ISBN 978-3-8055-9531-5
e-ISBN 978-3-8055-9532-2
Contents
Preface to the Second, Revised Edition
Wiersinga, W.M. (Amsterdam); Kahaly, G.J. (Mainz)
Preface to the First Edition
Wiersinga, W.M. (Amsterdam); Kahaly, G.J. (Mainz)
Diagnosis and Pathogenesis
Clinical Manifestations
Dickinson, A.J. (Newcastle upon Tyne)
What Are the Common Symptoms of Graves' Orbitopathy?
What Are the Common Signs of Graves' Orbitopathy?
What Signs Are Unusual in Graves' Orbitopathy?
Are There Racial Differences in How Graves' Orbitopathy Manifests?
Is the Presentation of Graves' Orbitopathy Different in Older Compared to Younger Patients?
Why Can the Clinical Presentation of Graves' Orbitopathy Be So Variable?
Can You Give Me a Short Mechanistic Explanation for All These Clinical Manifestations?
What Do the Terms Activity’ and ‘Severity’ Denote?
Why Is It Important to Distinguish Activity and Severity when Evaluating Patients?
What Symptoms and Signs Are Valuable for Assessing Activity?
How Are These Signs Assessed?
How Reproducible Are These Assessments?
What Value Does the ‘Clinical Activity Score’ Have?
Do Patients without Signs of Activity Ever Have Active Disease?
What Should I Do if I Am Not Sure whether the Disease Is Active?
Are There Any Other Ways to Evaluate Activity Other than Clinical Examination?
When Should These Other Methods for Assessing Activity Be Used in Routine Clinical Practice?
What Signs Are Helpful for Assessing Severity?
What Value Does the Mnemonic'NOSPECS' Have?
What Are the Relative Frequencies of Classes I-VI?
How Are Signs of Severity Assessed?
How Reproducible Are These Assessments?
How Do You Decide Whether a Patient Has Dysthyroid Optic Neuropathy?
Can Dysthyroid Optic Neuropathy Ever Be Present with Normal Vision?
Are Some Patients at Particular Risk?
What Other Assessments Are Useful in Evaluating Possible Dysthyroid Optic Neuropathy?
Should These Tests Be Performed in All Patients at Every Assessment?
Are There Any Other Assessment Systems in Common Use?
References
Orbit-Thyroid Relationship
Lazarus, J.H. (Cardiff); Marino, M. (Pisa)
Should This Condition Always Be Called Graves' Orbitopathy?
Does Graves' Orbitopathy Occur in the Absence of Hyperthyroidism?
Do All Patients with Graves' Disease Have Graves' Orbitopathy?
What Comes First in Graves' Disease? The Eye Changes or the Hyperthyroid Symptoms?
Do TSH Receptor Antibodies Also Cause GO?
Are There Any Other Extrathyroidal Manifestations of Graves' Disease Apart from Graves' Orbitopathy?
References
Epidemiology
Daumerie, C. (Brussels)
What Is the Present Estimated Prevalence of Graves' Orbitopathy? Has It Changed over the Last Decade?
Is the Age and Sex Distribution of Graves' Orbitopathy Similar to that of Graves' Disease?
Are There Ethnic Differences?
What Are the Risk Factors for the Occurrence of Graves' Orbitopathy?
Is Tobacco Bad for Graves' Orbitopathy?
Is Ocular Co-Morbidity Relevant for Graves' Orbitopathy?
Is Elevated Intraocular Pressure Relevant in Graves' Orbitopathy?
Is There Significant Non-Ocular Co-Morbidity (Like Diabetes) Which Is Relevant for Graves' Orbitopathy?
References
Pathogenesis
Orgiazzi, J. (Pierre-Bénite); Ludgate, M. (Cardiff)
What Are the Pathological Changes in Orbital Tissue in Graves' Orbitopathy?
How Do the Pathological Changes Give Rise to the Clinical Manifestations?
What Triggers Graves' Orbitopathy?
Is Graves' Orbitopathy Triggered by an Autoimmune Phenomenon? If So, What Is the Nature of the Autoantigen?
Why Is the Orbit Special and a Target for Thyroid Autoimmunity?
What Kind of Immune Reactions Take Place within the Orbit?
Does TSHR Activation and/or Autoreactivity to TSHR Play a Role in the Onset or Development of Graves' Orbitopathy?
Is There a Familial Predisposition or a Specific Genetic Background for Graves' Orbitopathy?
How Do Environmental Factors such as Smoking Increase the Risk and Severity of Graves' Orbitopathy?
How May These Observations and Current Understanding Lead to More Effective Treatment of Graves' Orbitopathy?
References
Orbital Imaging
Pitz, S. (Mainz)
Is Orbital Imaging Always Necessary?
What Are the Relative Benefits of Orbital CT and MRI?
What Is Apical Crowding?
What Is the Place of Orbital Ultrasound?
What Lessons Can We Learn from Orbital Octreoscan?
What Other Imaging Techniques May Be Useful?
Acknowledgments
References
Diagnosis and Differential Diagnosis of Graves' Orbitopathy
Mourits, M.P. (Amsterdam)
Can You Give an Overall Scheme for the Diagnosis of Graves' Orbitopathy?
Which Clinical Findings Are Helpful in Making a Diagnosis of Graves' Orbitopathy?
Can One Make a Diagnosis of Graves' Orbitopathy Based on Medical History and Clinical Picture Alone?
Do We Always Need to Order Thyroid Autoantibodies and Thyroid Function Tests?
Which Imaging Technique Is Best to Make a Diagnosis of Graves' Orbitopathy and Is Imaging Always Requested?
Which Are the Most Frequent Conditions Mimicking Graves' Orbitopathy?
Conclusion
References
Natural History
Pearce, S.; Kendall-Taylor, P. (Newcastle upon Tyne)
Does Graves' Orbitopathy Occur at the Same Time as Hyperthyroidism?
Does Restoring Euthyroidism Lead to Improvement in Graves' Orbitopathy?
What Effect May Hypothyroidism Have?
What Is the Typical Course of the Disease?
What Is the Difference between Activity and Severity?
How Do You Determine which Phase of the Disease the Patient Is Displaying?
How Does the Phase of the Disease Influence Choice of Treatment?
Will the GO Eventually Burn Itself Out?
Will the Orbital Changes Return to Normal when the Condition Eventually Resolves?
How Long Is it Likely to Take before the Disease Becomes Inactive?
Once the Condition Has Become Inactive (Whether Treated or Untreated) Is it Likely to Flare Up Again?
Are There Any Other Factors, Additional to Thyroid Status, which May Influence the Course of the Disease?
References
Management
General Management Plan
Boboridis, K. (Thessaloniki); Perros, P. (Newcastle upon Tyne)
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