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[A rare hyperthyroid syndrome].

V Artuso1, I Roiter

  • 1Medicina di Base, ASL Marcon, Venezia, Italy.

Minerva Endocrinologica
|July 17, 2004
PubMed
Summary
This summary is machine-generated.

The rare exophthalmos, myxedema, acropachy (EMA) syndrome, a complication of Graves

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Area of Science:

  • Endocrinology
  • Rheumatology
  • Dermatology

Background:

  • Exophthalmos, myxedema, acropachy (EMA) syndrome is a rare extrathyroidal complication of Graves' disease, affecting approximately 1% of patients.
  • The female-to-male ratio is 3.4:1, making this male case report exceptionally rare.

Observation:

  • A 52-year-old man presented with severe ophthalmopathy, pretibial myxedema, and acropachy with joint pain.
  • These symptoms manifested after treatments for ophthalmopathy, including thyroidectomy, retrobulbar steroid therapy, and radiotherapy.
  • The patient had normal thyroid function with T4 therapy, and EMA syndrome onset coincided with worsening ophthalmopathy.

Findings:

  • This case confirms the typical chronological sequence of extrathyroidal manifestations in autoimmune thyroid disease: thyroid disease, followed by ophthalmopathy, dermopathy, and acropachy.

Related Experiment Videos

  • Thyroid acropachy differs from other osteoarthropathies due to associated dermopathy and ophthalmopathy (EMA) and distinct subperiosteal proliferation.
  • Steroidal therapy effectively improved ophthalmopathy, pretibial myxedema, and acropachy, with faster resolution of exophthalmos and myxedema compared to acropachy.

    • Implications:

    • Acropachy represents the latest manifestation of EMA syndrome and correlates with ophthalmopathy exacerbation.
    • Traditional steroidal therapy remains an effective treatment for the multifaceted symptoms of EMA syndrome.
    • Understanding the chronological progression and treatment response in EMA syndrome aids in managing complex autoimmune thyroid complications.