Perepelova M A, Zaitseva E L, Bessmertnaya E G, Grusha Ya O, Sviridenko N Yu, Galstyan G R
Endocrinology Research Centre.
Research Institute of Eye Diseases.
Probl Endokrinol (Mosk). 2023 Aug 30;69(4):32-37. doi: 10.14341/probl12888.
Graves' disease (GD) is one of the urgent problems of modern endocrinology, characterized by a high frequency, polysystemic damage to the body, a steadily progressive course, diagnostic difficulties, a high degree of disability and often resistance to therapy. The manifestations of the disease include: thyrotoxicosis syndrome with impaired lipid and carbohydrate metabolism, and activation of multiple organ pathology in the form of thyroid eye disease (TED), pretibial myxedema, cardiovascular insufficiency, acropathy, lesions of the nervous, osteoarticular system, and other lesions. The development of multiple organ pathology can have a different sequence, different time intervals and different degrees of severity. Any developments in the direction of clarifying the etiopathogenetic, clinical diagnostic and treatment-rehabilitation measures are of undoubted significance. We present a clinical case of GD, TED and pretibial myxedema, in which an integrated approach was tested in the tactics of treating pretibial myxedema (a combination of pulse therapy with prednisolone and FREMS-therapy), as a result of which positive results were obtained within a short time.
格雷夫斯病（GD）是现代内分泌学的紧迫问题之一，其特点是发病率高、对身体造成多系统损害、病程呈稳步进展、诊断困难、致残程度高且常常对治疗耐药。该疾病的表现包括：伴有脂质和碳水化合物代谢受损的甲状腺毒症综合征，以及以甲状腺眼病（TED）、胫前黏液性水肿、心血管功能不全、肢端病、神经和骨关节系统病变等形式出现的多器官病变激活。多器官病变的发展可以有不同的顺序、不同的时间间隔和不同的严重程度。在明确病因发病机制、临床诊断以及治疗康复措施方面的任何进展都具有无疑的重要意义。我们展示了一例GD、TED和胫前黏液性水肿的临床病例，其中在胫前黏液性水肿的治疗策略中测试了一种综合方法（泼尼松龙脉冲疗法与FREMS疗法相结合），结果在短时间内获得了积极效果。
