ABSTRACT
A 59-year-old woman developed manifestations of Graves' disease several months after treatment with radioiodine (Na(131)) for toxic multinodular goitre. During subsequent treatment with additional radioiodine therapy Graves' ophthalmopathy developed which was severe and required treatment with prednisone and orbital radiotherapy. The literature on development of Graves' disease following Na(131) therapy is reviewed and possible pathophysiological mechanisms are discussed. In this case, possibly the first radioiodine therapy has illicited Graves' thyrotoxicosis and the subsequently added radioiodine treatments for the persistent Graves' thyrotoxicosis led to serious ophthalmopathy. Physicians should recognise Graves-like disease as a complication of Na(131)I therapy for toxic multinodular goitre and carefully consider the timing of consecutive radioiodine therapy.
Subject(s)
Goiter, Nodular/drug therapy , Graves Disease/chemically induced , Iodine Radioisotopes/adverse effects , Anti-Inflammatory Agents/therapeutic use , Drug Administration Schedule , Female , Goiter, Nodular/diagnostic imaging , Graves Disease/drug therapy , Graves Disease/radiotherapy , Humans , Iodine Radioisotopes/administration & dosage , Middle Aged , Prednisone/therapeutic use , Radionuclide Imaging , Time FactorsABSTRACT
In this report a woman with giant-cell arteritis presenting as an orbital pseudotumor is described. Other causes of orbital pseudotumor were excluded in this patient. The pathogenesis of orbital pseudotumor caused by giant-cell arteritis is discussed. The concurrent arteritis of the superficial temporal artery and the rapid resolution of signs and symptoms after prednisone therapy supports the causal relationship between orbital pseudotumor and giant-cell arteritis in this patient.
