甲状腺眼病令人困惑的晚期复发:一个案例系列
Eva Oustabassidis1, Noel Murphy2, Helen Elizabeth Turner3
1Ophthalmology Department, Oxford Eye Hospital, Oxford OX3 9DU, UK.
JCEM case reports
|March 27, 2025
概括
甲状腺眼病 (TED) 的晚期复发可能发生在最初呈现几十年后. 这个案例系列突出了TED重新激活的罕见实例,强调了临床医生意识和多式联络治疗策略的必要性.
科学领域:
- 眼科医生 眼科 眼科
- 内分泌学 在内分泌学.
- 自免疫性疾病 自免疫性疾病
背景情况:
- 甲状腺眼病 (TED) 通常是自我限制的,在18-36个月内消失.
- 经过5年的静止后,TED的晚期复发,定义为活跃的轨道病变,很少被记录下来.
- 了解晚期TED复发对于长期患者管理至关重要.
研究的目的:
- 报告和分析晚发性甲状腺眼病复发的罕见病例.
- 为了突出TED在最初诊断几十年后重新激活的潜力.
- 为了强调识别和管理迟到的TED复发的重要性.
主要方法:
- 在2016年至2024年期间经历TED复发的患者的回顾性审计.
- 包含了三个不同的案例,与最初的TED演讲有很大的时间间隔.
- 通过临床评估,TRAb水平和放射性成像来确认复发.
主要成果:
- 确定了三起TED复发的晚期病例,发生在9,20和40年后的初始发作.
- 所有的患者都出现了确定的活跃轨道病变.
- 包括生物药物,类固醇,免疫抑制剂,放射治疗和手术在内的多模式治疗在所有病例中都导致了疾病静止.
结论:
- 甲状腺眼病可能会出现晚发性复发,甚至在原始疾病发生几十年后.
- 这些复发可能是严重的,需要全面的多模式治疗方法.
- 临床医生必须保持对潜在的TED复发的认识,并在出院后相应地向患者提供建议.
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