Thyroid Associated Ophthalmopathy with Ocular Myasthenia in Primary Hypothyroidism
A 62-year-female presented with bilateral proptosis and 1 year episodic eye pain, grittiness, redness, watering and intermittent diplopia for 6 months, and drooping of right eye lid for 2 months (Figure 1). She had a firm WHO grade-1b goiter, exopthalmos (26 mm and 23 mm in left and right eye respectively, Hertel exopthalmometer), clinical activity score of 1/6, without any evidence of bulbar, neck muscles and limb weakness.
Eckstein AK, Lösch C, Glowacka D, Schott M, Mann K, Esser J, Morgenthaler NG. Euthyroid and primarily hypothyroid patients develop milder and significantly more asymmetrical Graves’ ophthalmopathy. Br J Ophthalmol.2009;93:1052-6.
Drachman D. Myasthenia gravis and other diseases of neuromuscular junction. In: Fauci A, Braunwald E, Kasper D, Hauser L. Harrison’s Principles of Internal Medicine. 17th Edition Volume-2, McGraw Hill. 2008; 2675.
Zouvelou V, Potagas C, Karandreas N, Rentzos M, Papadopoulou M, Zis VP, Vassilopoulos D. Concurrent presentation of ocular myasthenia and euthyroid Graves ophthalmopathy: A diagnostic challenge. J Clin Neurosci. 2008;15:719-20.
Journal of the ASEAN Federation of Endocrine Societies is licensed under a Creative Commons Attribution-NonCommercial 4.0 International. (full license at this link: http://creativecommons.org/licenses/by-nc/3.0/legalcode).
To obtain permission to translate/reproduce or download articles or use images FOR COMMERCIAL REUSE/BUSINESS PURPOSES from the Journal of the ASEAN Federation of Endocrine Societies, kindly fill in the Permission Request for Use of Copyrighted Material and return as PDF file to email@example.com or firstname.lastname@example.org.
A written agreement shall be emailed to the requester should permission be granted.