Moreno Martínez J M, Martín Araguz A, Margalet Fernández P, García de la Rocha M L, Garrido Carrión A
An Med Interna. 1989 Jan;6(1):26-8.
A 74 year old, male patient had an acute, painful bilateral exophtalmos, ptosis, ophtalmopathy and vision impairment. The CT-scan showed a thickness of the extrinsic ocular muscles which oriented the diagnosis of Graves-Basedow disease, later confirmed by the laboratory test. We highlight the rarity of the acute onset contrary to the slowly progressive ophtalmopathy frequently seen in this type of thyrotoxicosis, as well as the importance of the orbital CT-scan for an early diagnosis. We review the pathogenic theories of the process with its important immunologic back-ground, taking part the humoral and the cellular immunity associated with the HLA-B35 haplotype commenting on the good response to high dosage of steroids, later combined with bromocriptine.
一名74岁男性患者出现急性、疼痛性双侧眼球突出、上睑下垂、眼病和视力损害。CT扫描显示眼外肌增厚，据此诊断为格雷夫斯-巴塞多病，随后实验室检查得以证实。我们强调与这种甲状腺毒症中常见的缓慢进展性眼病相反，急性起病的罕见性，以及眼眶CT扫描对早期诊断的重要性。我们回顾了该疾病过程的致病理论及其重要的免疫背景，涉及与HLA-B35单倍型相关的体液免疫和细胞免疫，并评论了高剂量类固醇随后联合溴隐亭的良好反应。
