Thyroid-Associated Ophthalmopathy in a Hypothyroid Patient
Thyroid-associated ophthalmopathy (TAO) is an autoimmune disorder of the orbit that occurs predominantly in Grave’s hyperthyroidism, while it is an uncommon clinical finding in patients with Hashimoto’s thyroiditis (HT) and hypothyroidism. We report the case of a 62-year-old female patient who pr...
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Sestre Milosrdnice University hospital, Institute of Clinical Medical Research
2024-01-01
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| Series: | Acta Clinica Croatica |
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| Online Access: | https://hrcak.srce.hr/file/482186 |
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| author | Dorotea Filipan Renata Iveković Tomislav Gregurić Zvonko Kusić Tomislav Jukić |
| author_facet | Dorotea Filipan Renata Iveković Tomislav Gregurić Zvonko Kusić Tomislav Jukić |
| author_sort | Dorotea Filipan |
| collection | DOAJ |
| description | Thyroid-associated ophthalmopathy (TAO) is an autoimmune disorder of the orbit
that occurs predominantly in Grave’s hyperthyroidism, while it is an uncommon clinical finding in
patients with Hashimoto’s thyroiditis (HT) and hypothyroidism. We report the case of a 62-year-old female
patient who presented with left eyelid edema, proptosis, diplopia, and lateral paralysis of the left eye.
Magnetic resonance imaging of the orbits showed retrobulbar mass in the left orbit with hyperintense
signals within left medial rectus muscle, offsetting but not infiltrating the optic nerve. An 18F-fluorodeoxyglucose
positron-emission tomography/computed tomography (18F-FDG PET/CT) scan revealed
pathological 18F-FDG uptake of expansive mass within rectus medialis muscle of the left eye (SUVmax=
11.0) and similar findings in the right eye (SUVmax=7.1). It also displayed increased glucose
metabolism in the thyroid gland (SUVmax=6.4). Laboratory findings showed increased thyrotropin level,
while thyroid-stimulating-hormone-receptor antibodies were negative. The patient was diagnosed with
HT and TAO, so levothyroxine therapy was introduced. Gradual improvement of TAO symptoms was
attained a year later. Diplopia subsided and the patient regained complete eye movements. In conclusion,
correction of hypothyroidism can significantly improve symptoms of TAO. Additional value of this case
report lies in 18F-FDG PET/CT images displaying increased |
| format | Article |
| id | doaj-art-0599859d58b343de9880b2c0bcaa1db5 |
| institution | OA Journals |
| issn | 0353-9466 1333-9451 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Sestre Milosrdnice University hospital, Institute of Clinical Medical Research |
| record_format | Article |
| series | Acta Clinica Croatica |
| spelling | doaj-art-0599859d58b343de9880b2c0bcaa1db52025-08-20T02:36:07ZengSestre Milosrdnice University hospital, Institute of Clinical Medical ResearchActa Clinica Croatica0353-94661333-94512024-01-0163.3-482282610.20471/acc.2024.63.03-04.46Thyroid-Associated Ophthalmopathy in a Hypothyroid PatientDorotea Filipan0Renata Iveković1Tomislav Gregurić2Zvonko Kusić3Tomislav Jukić4Department of Oncology and Nuclear Medicine, Sestre milosrdnice University Hospital Center, Zagreb, CroatiaDepartment of Ophthalmology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia; School of Dental Medicine, University of Zagreb, Zagreb, CroatiaDepartment of Diagnostic and Interventional Radiology, Sestre milosrdnice University Hospital Center, Zagreb, CroatiaCroatian Academy of Sciences and Arts, Zagreb, CroatiaDepartment of Oncology and Nuclear Medicine, Sestre milosrdnice University Hospital Center, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, CroatiaThyroid-associated ophthalmopathy (TAO) is an autoimmune disorder of the orbit that occurs predominantly in Grave’s hyperthyroidism, while it is an uncommon clinical finding in patients with Hashimoto’s thyroiditis (HT) and hypothyroidism. We report the case of a 62-year-old female patient who presented with left eyelid edema, proptosis, diplopia, and lateral paralysis of the left eye. Magnetic resonance imaging of the orbits showed retrobulbar mass in the left orbit with hyperintense signals within left medial rectus muscle, offsetting but not infiltrating the optic nerve. An 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (18F-FDG PET/CT) scan revealed pathological 18F-FDG uptake of expansive mass within rectus medialis muscle of the left eye (SUVmax= 11.0) and similar findings in the right eye (SUVmax=7.1). It also displayed increased glucose metabolism in the thyroid gland (SUVmax=6.4). Laboratory findings showed increased thyrotropin level, while thyroid-stimulating-hormone-receptor antibodies were negative. The patient was diagnosed with HT and TAO, so levothyroxine therapy was introduced. Gradual improvement of TAO symptoms was attained a year later. Diplopia subsided and the patient regained complete eye movements. In conclusion, correction of hypothyroidism can significantly improve symptoms of TAO. Additional value of this case report lies in 18F-FDG PET/CT images displaying increasedhttps://hrcak.srce.hr/file/482186Thyroid-associated ophthalmopathyHashimoto’s thyroiditishypothyroidismMagnetic resonance imaging18F-FDG PET/CT |
| spellingShingle | Dorotea Filipan Renata Iveković Tomislav Gregurić Zvonko Kusić Tomislav Jukić Thyroid-Associated Ophthalmopathy in a Hypothyroid Patient Acta Clinica Croatica Thyroid-associated ophthalmopathy Hashimoto’s thyroiditis hypothyroidism Magnetic resonance imaging 18F-FDG PET/CT |
| title | Thyroid-Associated Ophthalmopathy in a Hypothyroid Patient |
| title_full | Thyroid-Associated Ophthalmopathy in a Hypothyroid Patient |
| title_fullStr | Thyroid-Associated Ophthalmopathy in a Hypothyroid Patient |
| title_full_unstemmed | Thyroid-Associated Ophthalmopathy in a Hypothyroid Patient |
| title_short | Thyroid-Associated Ophthalmopathy in a Hypothyroid Patient |
| title_sort | thyroid associated ophthalmopathy in a hypothyroid patient |
| topic | Thyroid-associated ophthalmopathy Hashimoto’s thyroiditis hypothyroidism Magnetic resonance imaging 18F-FDG PET/CT |
| url | https://hrcak.srce.hr/file/482186 |
| work_keys_str_mv | AT doroteafilipan thyroidassociatedophthalmopathyinahypothyroidpatient AT renataivekovic thyroidassociatedophthalmopathyinahypothyroidpatient AT tomislavgreguric thyroidassociatedophthalmopathyinahypothyroidpatient AT zvonkokusic thyroidassociatedophthalmopathyinahypothyroidpatient AT tomislavjukic thyroidassociatedophthalmopathyinahypothyroidpatient |