Graves  Orbitopathy
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Ten years ago, the first edition of Graves’ Orbitopathy: A Multidisciplinary Approach was published. Since then, the book has become very popular and much has happened in the field to warrant a third edition. What has not changed is the successful and attractive question-and-answer format of the book. In the 3rd, revised and expanded edition, new chapters have been added on co-morbidity, local treatment modalities, novel immunosuppressive therapy, detailed protocols, and questions frequently asked by patients. All chapters of the previous edition have been thoroughly updated. Subjects covered then include the pathology of Graves’ Orbitopathy (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. Additionally, ample consideration is given to the new 2016 ETA/EUGOGO guidelines on the management of GO.



Publié par
Date de parution 21 août 2017
Nombre de lectures 0
EAN13 9783318060850
Langue English
Poids de l'ouvrage 2 Mo

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Graves’ Orbitopathy
A Multidisciplinary Approach – Questions and Answers
3rd, revised and expanded edition
Graves’ Orbitopathy
A Multidisciplinary Approach – Questions and Answers
3rd, revised and expanded edition
Wilmar M. Wiersinga Amsterdam
George J. Kahaly Mainz
116 figures, 69 in color, and 52 tables, 2017
_______________________ 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
Names: Wiersinga, Wilmar M., editor. | Kahaly, George, editor.
Title: Graves' orbitopathy : a multidisciplinary approach : questions and answers / editors, Wilmar M. Wiersinga, George J. Kahaly.
Description: 3rd, revised and expanded edition. | Basel ; New York : Karger, 2017. | Includes bibliographical references and indexes.
Identifiers: LCCN 2017031321| ISBN 9783318060843 (softcover : alk. paper) | ISBN 9783318060850 (electronic version)
Subjects: | MESH: Graves Ophthalmopathy--diagnosis | Graves Ophthalmopathy--pathology | Graves Ophthalmopathy--therapy | Ophthalmologic Surgical Procedures | Diagnosis, Differential | Ophthalmologic Surgical Procedures
Classification: LCC RE715.T48 | NLM WK 265 | DDC 617.7--dc23
LC record available at
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 2017 by S. Karger AG, P.O. Box, CH–4009 Basel (Switzerland)
Printed on acid-free and non-aging paper (ISO 9706)
ISBN 978–3–318–06084–3
e-ISBN 978–3–318–06085–0
Preface to the Third, Revised and Expanded Edition
Wiersinga, W.M. (Amsterdam); Kahaly, G.J. (Mainz)
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); Hintschich, C. (Munich)
What Are the Common Signs and Symptoms of Early Graves’ Orbitopathy?
What Are Other Signs and Symptoms of Graves’ Orbitopathy?
What Signs Should Question the Diagnosis of 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 Signs and Symptoms 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?
How Are Signs of Severity Assessed?
How Reproducible Are These Assessments?
How Is Severity Best Classified?
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?
Orbit-Thyroid Relationship
Marinò, M. (Pisa)
Should This Condition Always Be Called Graves’ Orbitopathy?
Is Graves’ Orbitopathy Exclusively Occurring in Patients with Graves’ Hyperthyroidism?
Do All Patients with Graves’ Hyperthyroidism Have Graves’ Orbitopathy?
Are There Any Relationships between Hyperthyroidism, Hypothyroidism, and Graves’ Orbitopathy?
Is Graves’ Orbitopathy Related to Thyroid Autoimmunity?
Are There Other Extrathyroidal Manifestations of Graves’ Disease apart from Graves’ Orbitopathy?
Burlacu, M.-C.; Daumerie, C. (Brussels)
What Is the Estimated Incidence and Prevalence of Graves’ Orbitopathy?
Has the Occurrence of Graves’ Orbitopathy Changed over the Last Few Decades?
Is the Age and Sex Distribution of Graves’ Orbitopathy Similar to That of Graves’ Hyperthyroidism?
Are There Ethnic Differences?
What Are the Risk Factors for the Occurrence of Graves’ Orbitopathy?
Can Particular Drugs Trigger or Modify Graves’ Orbitopathy and Its Course?
Is Tobacco Bad for Graves’ Orbitopathy?
Has Nutrition an Effect on Graves’ Orbitopathy?
Does Total Thyroidectomy for Other Diseases than Graves’ Disease Preclude the Development of Graves’ Orbitopathy?
Salvi, M. (Milan); Berchner-Pfannschmidt, U. (Essen); 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 Thyroid-Stimulating Hormone Receptor Activation and/or Autoreactivity to Thyroid-Stimulating Hormone Receptor 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 Increase the Risk and Severity of Graves’ Orbitopathy?
How May These Observations and Current Understanding Lead to More Effective Treatment of Graves’ Orbitopathy?
Orbital Imaging
Pitz, S.; Müller-Forell, W. (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?
Diagnosis and Differential Diagnosis of Graves’ Orbitopathy
Konuk, O. (Ankara); Anagnostis, P. (Thessaloniki)
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 Autoantibody 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?
Natural History
Mamoojee, Y.; Pearce, S.H.S. (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?

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