Different therapeutic outcomes in two cases with active moderate-to-severe Graves'orbitopathy treated with intravenous steroid therapy-case presentation

2014 ◽  
Author(s):  
Ioana Zosin ◽  
Mihaela Vlad ◽  
Melania Balas ◽  
Carmen Bolintineanu
Keyword(s):  
Steroid Therapy ◽  
Case Presentation ◽  
Intravenous Steroid ◽  
Therapeutic Outcomes

In iodine-induced thyrotoxicosis, steroid therapy today could keep the surgical knife at bay

2018 ◽  
Vol 31 (5) ◽  
pp. 585-588 ◽  
Author(s):  
Rohan K. Henry ◽  
Monika Chaudhari
Keyword(s):  
Steroid Therapy ◽  
Medical Literature ◽  
Urinary Iodine ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Function Tests ◽  
Case Presentation ◽  
Total Triiodothyronine ◽  
History Of ◽  
Daily Allowance

Abstract Background: Amiodarone-induced thyrotoxicosis (AIT) type 2, characterized as a destructive thyroiditis, is well described in the medical literature; however, iodine-induced thyrotoxicosis (IIT) is not, though the latter has similar features and can be managed similarly. Case presentation: We present a 17-year-old female who presented with a history of an intermittent goiter with thyroid function tests (TFTs): thyroid-stimulating hormone (TSH)<0.015 (0.4–4 μU/mL), free thyroxine (T4)≥6 (0.7–2.1 ng/dL) and total triiodothyronine (T3) 651 (50–200 mg/dL). Thyroid antibodies were all negative. Despite methimazole therapy for 6 weeks, hyperthyroidism proved refractory to medical management. 123I scan uptake was suppressed. With hyperthyroidism being recalcitrant to therapy, a nutritional history revealed consumption of an iodine supplement containing at least 7 times the recommended daily allowance (RDA) for 5 years, contributing to the Jod-Basedow phenomenon. Urinary spot and 24-hour urinary iodine were both elevated. Though a surgical consult was obtained, surgery was cancelled once TFTs improved and then normalized with steroid therapy. The TFTs and urinary iodine levels remained normal post steroid therapy. Conclusions: We suggest that in addition to the need for a thorough nutritional history, a trial of corticosteroids should be utilized in the management of IIT which can present with findings similar to AIT type 2 which is recalcitrant to thionamide therapy. If successful, corticosteroids may delay or prevent surgical management thus avoiding possible complications with the latter approach.

AMINOPHYLLINE THERAPY DOES NOT IMPROVE OUTCOME AND INCREASE ADVERSE EFFECTS IN CHILDREN HOSPITALIZED WITH ACUTE ASTHMATIC EXACERBATIONS

PEDIATRICS ◽  
1995 ◽  
Vol 96 (2) ◽  
pp. 400-400
Author(s):  
Clifton T. Furukawa
Keyword(s):  
Adverse Effects ◽  
Steroid Therapy ◽  
Improve Outcome ◽  
Intravenous Steroid

There was no benefit and increased adverse effects associated with the use of aminophylline in addition to standard albuterol and intravenous steroid therapy.

scholarly journals 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

2014 ◽  
Vol 170 (1) ◽  
pp. 55-61 ◽  
Author(s):  
Guia Vannucchi ◽  
Danila Covelli ◽  
Irene Campi ◽  
Daniele Origo ◽  
Nicola Currò ◽  
...  
Keyword(s):  
Glucocorticoid Receptor ◽  
Gene Polymorphisms ◽  
Response To Therapy ◽  
Therapeutic Outcome ◽  
Clinical Activity ◽  
Treatment Schedule ◽  
Intravenous Steroid ◽  
Therapeutic Outcomes ◽  
Variable Sensitivity ◽  
Graves Orbitopathy

BackgroundGlucocorticoids are the mainstay of immunosuppression for active moderate–severe Graves' orbitopathy (GO).AimTo analyze the response to therapy and the contribution of glucocorticoid receptor (GR) gene polymorphisms to the therapeutic outcome of intravenous glucocorticoids (IVGC) in active moderate–severe GO.MethodsWe have studied 58 patients treated with 7.5 g i.v. methylprednisolone (cumulative dose). Ophthalmological assessment was performed at baseline and at 6–8, 12–16, and 24–30 weeks after the first infusion. Three GR gene polymorphisms, ER22/23EK, N363S, and BCL1, which have been associated to variable sensitivity to steroids, were studied in 43/58 patients. The therapeutic outcomes defined as: i) reduction of the clinical activity score (CAS) ≥2 points or ii) reduction of proptosis ≥2 mm or iii) improvement of diplopia according to the Gorman score were also studied in relation to treatment schedule, age, gender, duration of thyroid or GO, smoking habits, and serum TSH-receptor autoantibodies levels.ResultsIn total, 70% of patients responded and had GO inactivation (CAS <4) as early as 6–8 weeks. At 12–16 weeks, the proportion of patients who became inactive increased by another 10% up to a total of 80%. ER22/23EK and N363S polymorphisms were present only in about 7%, while the Bcl1 variant was present in 30% of patients; no significant association of any of the GR polymorphisms with either the therapeutic response or the occurrence of side effects was observed.ConclusionsMost patients with active GO respond to IVGC as early as 6–8 weeks of therapy and the analyzed GR polymorphisms do not influence the therapeutic effect of steroids. Questions arise about the need of continuing therapy up to 12 weeks in nonresponders. We suggest that these patients may be switched to other treatments alone or in combination with steroids.

Onset of Autoimmune Hepatitis During Intravenous Steroid Therapy for Thyroid-Associated Ophthalmopathy in a Patient with Hashimoto's Thyroiditis: Case Report

Thyroid ◽  
2004 ◽  
Vol 14 (8) ◽  
pp. 631-634 ◽  
Author(s):  
Mario Salvi ◽  
Guia Vannucchi ◽  
Francesco Sbrozzi ◽  
Alessandra Bottari Del Castello ◽  
Alessandra Carnevali ◽  
...  
Keyword(s):  
Case Report ◽  
Autoimmune Hepatitis ◽  
Steroid Therapy ◽  
Hashimoto’S Thyroiditis ◽  
Hashimoto's Thyroiditis ◽  
Intravenous Steroid ◽  
Thyroid Associated Ophthalmopathy

scholarly journals Review of the role of Magnesium Sulphate in the Management of Asthma patient at A&E Setting

2003 ◽  
Vol 10 (1) ◽  
pp. 37-42 ◽  
Author(s):  
YY Yan ◽  
MH Ng
Keyword(s):  
Steroid Therapy ◽  
Magnesium Sulphate ◽  
Asthma Patient ◽  
Bronchodilator Therapy ◽  
Asthmatic Attack ◽  
Intravenous Steroid ◽  
Intravenous Magnesium ◽  
Severe Asthmatic

Controversial views exist with regards to the use of intravenous magnesium sulphate in patient with severe asthmatic attack. The benefit of intravenous magnesium sulphate may be masked by the pooling of patients with different pathophysiology. The subsets of patients with severe asthmatic attack who have not responded to nebulised bronchodilator therapy and intravenous steroid therapy may benefit from intravenous magnesium sulphate therapy.

Successful presurgical management by intravenous steroid therapy in spinal dural arteriovenous fistula

2013 ◽  
Vol 1 (3) ◽  
pp. 122-124
Author(s):  
Hideyuki Matsumoto ◽  
Shunsuke Ichi ◽  
Taro Bannai ◽  
Yukifusa Igeta ◽  
Ichiro Suzuki ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Steroid Therapy ◽  
Dural Arteriovenous Fistula ◽  
Spinal Dural Arteriovenous Fistula ◽  
Intravenous Steroid

scholarly journals Reconstruction of Photoreceptor Outer Layers after Steroid Therapy in Solar Retinopathy

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Masaki Nakamura ◽  
Koji Komatsu ◽  
Satoshi Katagiri ◽  
Takaaki Hayashi ◽  
Tadashi Nakano
Keyword(s):  
Steroid Therapy ◽  
Clinical Course ◽  
Oral Prednisolone ◽  
Central Scotoma ◽  
Case Presentation ◽  
Ellipsoid Zone ◽  
Corrected Visual Acuity ◽  
Interdigitation Zone ◽  
The Right ◽  
Best Corrected Visual Acuity

Purpose. To report the clinical course of solar retinopathy after steroid therapy. Case Presentation. A 45-year-old male gazed at the sun and noticed bilateral central scotoma and decreased vision after the episode. After 7 weeks from onset, ophthalmic examinations were firstly performed. Decimal best corrected visual acuity (BCVA) was decreased to 0.8 and 0.7 in the right and left eyes. Funduscopy showed a tiny, yellowish spot in the fovea bilaterally. Corresponding to the lesion, optical coherence tomography (OCT) images showed an elevated and blurred ellipsoid zone and loss of the interdigitation zone. A posterior sub-Tenon triamcinolone injection in the right eye and oral prednisolone therapy were performed as a medication. BCVA was improved to 1.2 and 1.0 in the right and left eyes at 9 weeks after medication. OCT images showed ellipsoid zone was gradually improved bilaterally, which became nearly normal at 4 weeks in the right eye and at 21 weeks in the left eye. The loss of the interdigitation zone remained at 12 weeks in the right eye and at 21 weeks at the left eye. Conclusions. We described a case with solar retinopathy who exhibited anatomical recovery of the photoreceptor outer layers by steroid therapy, started after 7 weeks from onset.

Bilateral Postinfectious Optic Neuritis and Intravenous Steroid Therapy in Children

Ophthalmology ◽  
1990 ◽  
Vol 97 (3) ◽  
pp. 339-345 ◽  
Author(s):  
Bradley K. Farris ◽  
Darrell J. Pickard
Keyword(s):  
Optic Neuritis ◽  
Steroid Therapy ◽  
Intravenous Steroid
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