Winand R J, Cornet G, Etienne-Decerf J, Wadeleux P, Glinoer D
Institute of Pathology, Centre Hospitalier Universitaire, Sart Tilman par Liège I, Belgium.
Metab Pediatr Syst Ophthalmol (1985). 1988;11(3):126-32.
In the present work, we demonstrate in the serum of patients with progressive exophthalmos, the presence of circulating immunoglobulin which is able to induce an experimental exophthalmos in goldfish. This immunoglobulin disappears when exophthalmos becomes residual. In parallel, we describe an easy technique for the measurement of delayed hypersensitivity which is positive for thyroid or retroorbital antigens in progressive exophthalmos but negative in residual exophthalmos. We also demonstrate in patients with exophthalmos an increase in urinary glycosaminoglycans. We propose a new therapeutic approach in treatment of acute exophthalmos which consists of intensive plasma exchange followed during a few months, by the administration of small amounts of corticosteroids. The plasma exchange mechanism consists of the extraction of the antibody directed against retroorbital eye muscle antigen. In addition, plasma exchange produces the extraction of glycosaminoglycans from retroorbital tissue. These hygroscopic molecules are responsible for the marked oedema in retroorbital tissue.
在本研究中，我们证实在进行性眼球突出患者的血清中存在循环免疫球蛋白，该球蛋白能够在金鱼中诱发实验性眼球突出。当眼球突出变为残留性时，这种免疫球蛋白消失。同时，我们描述了一种测量迟发型超敏反应的简便技术，该技术在进行性眼球突出中对甲状腺或眶后抗原呈阳性，但在残留性眼球突出中呈阴性。我们还证实在眼球突出患者中尿糖胺聚糖增加。我们提出了一种治疗急性眼球突出的新方法，该方法包括强化血浆置换，随后在几个月内给予少量皮质类固醇。血浆置换机制包括提取针对眶后眼肌抗原的抗体。此外，血浆置换可从眶后组织中提取糖胺聚糖。这些吸湿分子是眶后组织明显水肿的原因。
