El-Kaissi Samer, Wall Jack R
Specialized Diabetes and Endocrine Centre, King Fahad Medical City, Dabab Street, P.O. Box 59046, Riyadh 11525, Saudi Arabia.
J Thyroid Res. 2012;2012:368536. doi: 10.1155/2012/368536. Epub 2012 Feb 15.
Background. To examine factors contributing to extraocular muscle (EOM) volume enlargement in patients with Graves' hyperthyroidism. Methods. EOM volumes were measured with orbital magnetic resonance imaging (MRI) in 39 patients with recently diagnosed Graves' disease, and compared to EOM volumes of 13 normal volunteers. Thyroid function tests, uptake on thyroid scintigraphy, anti-TSH-receptor antibody positivity and other parameters were then evaluated in patients with EOM enlargement. Results. 31/39 patients had one or more enlarged EOM, of whom only 2 patients had clinical EOM dysfunction. Compared to Graves' disease patients with normal EOM volumes, those with EOM enlargement had significantly higher mean serum TSH (0.020 ± 0.005 versus 0.007 ± 0.002 mIU/L; P value 0.012), free-T4 (52.9 ± 3.3 versus 41.2 ± 1.7 pmol/L; P value 0.003) and technetium uptake on thyroid scintigraphy (13.51 ± 1.7% versus 8.55 ± 1.6%; P value 0.045). There were no differences between the 2 groups in anti-TSH-receptor antibody positivity, the proportion of males, tobacco smokers, or those with active ophthalmopathy. Conclusions. Patients with recently diagnosed Graves' disease and EOM volume enlargement have higher serum TSH and more severe hyperthyroidism than patients with normal EOM volumes, with no difference in anti-TSH-receptor antibody positivity between the two groups.
背景。研究格雷夫斯甲状腺功能亢进症患者眼外肌（EOM）体积增大的相关因素。方法。对39例新诊断的格雷夫斯病患者进行眼眶磁共振成像（MRI）测量眼外肌体积，并与13名正常志愿者的眼外肌体积进行比较。然后对眼外肌增大的患者进行甲状腺功能检查、甲状腺闪烁显像摄取情况、抗促甲状腺激素受体抗体阳性情况及其他参数评估。结果。39例患者中有31例存在一条或多条眼外肌增大，其中仅有2例有临床眼外肌功能障碍。与眼外肌体积正常的格雷夫斯病患者相比，眼外肌增大的患者血清促甲状腺激素平均水平显著更高（0.020±0.005对0.007±0.002 mIU/L；P值0.012）、游离T4水平更高（52.9±3.3对41.2±1.7 pmol/L；P值0.003）以及甲状腺闪烁显像锝摄取率更高（13.51±1.7%对8.55±1.6%；P值0.045）。两组在抗促甲状腺激素受体抗体阳性率、男性比例、吸烟者比例或活动性眼病患者比例方面无差异。结论。新诊断的格雷夫斯病且眼外肌体积增大的患者比眼外肌体积正常的患者血清促甲状腺激素水平更高，甲亢更严重，两组抗促甲状腺激素受体抗体阳性率无差异。
