Pathogenesis of Graves' ophthalmopathy
Article Abstract:
Most patients with Graves' hyperthyroidism develop some degree of eye abnormalities, including protrusion of the eye (exophthalmos) and enlarged eye muscles. A recent study indicates that these complications may be caused by some of the treatments used in Graves' disease, such as iodine-131 or anti-thyroid drugs. The incidence of eye abnormalities, or ophthalmopathy, was higher in older patients who were treated with iodine-131, and the abnormalities were more severe. However, the patients treated with iodine-131 were hypothyroid, and may have had high blood levels of thyrotropin. Excessive levels of thyrotropin could activate immune cells that stimulate the growth of connective tissue cells around the eye, causing it to enlarge. In addition, iodine-131 may cause an autoimmune condition in which the body produces antibodies against the thyroid as well as the eye. Individuals who will be receiving iodine-131 therapy can be treated with thyroxine to reduce their thyrotropin levels, or they can be given anti-thyroid drugs instead of iodine-131.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1992
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Cigarette smoking and the thyroid
Article Abstract:
Cigarettes, as well as iodine and lithium, may have various effects on the thyroid gland and play a role in abnormal thyroid function. A 1995 study found that smoking inhibited the production and action of thyroid hormone in women with a deficiency of thyroid activity called hypothyroidism. This study does not suggest that smoking causes hypothyroidism, only that it may worsen the condition. Another study indicated that smoking was associated with Graves' hyperthyroidism and the eye disease that is associated with it. However, the actual physiologic mechanism by which tobacco affects the thyroid is unclear. Low iodine intake can cause goiter and cretinism. Excessive iodine intake, and the antidepressant lithium can cause both increased and decreased thyroid activity.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1995
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