Skip to main content
SpringerLink
Log in

Epatopatia e glucocorticoidi nella oftalmopatia basedowiana: un limite alla terapia?

  • Published:
L’Endocrinologo Aims and scope

Riassunto

I glucocorticoidi (GC) per via endovenosa (ev) rappresentano lo strumento terapeutico più diffuso ed efficace per l’oftalmopatia basedowiana (OB). Tuttavia, l’osservazione di alcuni casi di danno epatico acuto (DEA) durante o dopo terapia con GC ev ha sollevato importanti interrogativi sulla sicurezza di questo tipo di terapia e sull’opportunità di effettuarla indiscriminatamente in tutti i pazienti con OB in cui sarebbe indicata. Un importante aspetto da considerare è se l’osservazione di DEA durante o dopo terapia con GC ev sia un evento casuale, o da mettere effettivamente in relazione con la terapia. A tale proposito, non esistono studi epidemiologici che consentano di confrontare la frequenza del DEA tra pazienti trattati con GC ev e popolazione generale. In questo articolo abbiamo analizzato in maniera retrospettiva i casi di DEA riportati in letteratura e gli studi su casistica disponibili, allo scopo di valutarne la frequenza e individuarne i possibili predisponenti.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Bibliografia

  1. Burch HB, Wartofski L. Graves’ ophthalmopathy: Current concepts regarding pathogenesis and management. Endocr Rev 14: 747, 1993.

    CAS  PubMed  Google Scholar 

  2. Bartalena L, Pinchera A, Marcocci C. Management of Graves’ ophthalmopathy: reality and perspectives. Endocr. Rev. 21: 168, 2000.

    CAS  PubMed  Google Scholar 

  3. Prummel MF. Pathogenetic and clinical aspects of endocrine ophthalmopathy. Exp Clin Endocrinol Diab 107(Suppl 3): S75, 1999.

    Article  CAS  Google Scholar 

  4. Bahn RS, Heufelder AE. Pathogenesis of Graves’ ophthalmopathy. N Engl J Med 329: 1468, 1993.

    Article  CAS  PubMed  Google Scholar 

  5. Bartalena L, Marcocci C, Tanda ML, Rocchi R, Mazzi B, Barbesino G, Pinchera A. Orbital radiotherapy for Graves’ophthalmopathy. Thyroid 12: 245, 2002.

    Article  PubMed  Google Scholar 

  6. Marcocci C, Marinò M, Rocchi R, Menconi F, Morabito E, Pinchera A. Novel aspects of immunosuppressive and radiotherapy management of Graves’ophthalmopathy. J Endocrinol Invest 27: 272, 2004.

    CAS  PubMed  Google Scholar 

  7. Bartalena L, Marcocci C, Gorman CA, Wiersinga WM, Pinchera A. Orbital radiotherapy for Graves’ophthalmopathy: useful or useless? Safe or dangerous? J Endocrinol Invest 26: 5, 2003.

    CAS  PubMed  Google Scholar 

  8. Nagayama Y, Izumi M, Kiriyama T, Yokoyama N, Morita S, Kazekono F, Ohtakara S, Morimoto I, Okamotot S, Nagataki S. Treatment of Graves’ophthalmopathy with high-dose intravenous methylprednisolone pulse therapy. Acta Endocrinol (Copenh) 116: 513, 1987.

    CAS  Google Scholar 

  9. Weissel M, Hauff W. Fatal acute liver failure after high-dose glucocorticoid pulse therapy in a patient with severe thyroid eye disease. Thyroid 10: 521, 2000.

    CAS  PubMed  Google Scholar 

  10. Dourakis SP, Sevastianos VA, Kalipi P. Acute severe steatohepatitis related to prednisolone therapy. Am J Gastroenterol. 97: 1074, 2002.

    Article  CAS  PubMed  Google Scholar 

  11. Nanki T, Koike R, Miyasaka N. Subacute severe steatohepatitis during prednisolone therapy for systemic lupus erythematosus. Am J Gastroenterol 94: 3379, 1999.

    Article  CAS  PubMed  Google Scholar 

  12. Marino M, Morabito E, Brunetto MR, Bartalena L, Marcocci C, Pinchera A. Acute and severe liver damage associated with intravenous glucocorticoid pulse therapy in patients with Graves’ ophthalmopathy. Thyroid 14: 403, 2004.

    Article  PubMed  Google Scholar 

  13. Salvi M, Vannucchi G, Sbrozzi F, Del Castello AB, Carnevali A, Fargion S, Beck-Peccoz P. Onset of autoimmune hepatitis during intravenous steroid therapy for thyroid-associated ophthalmopathy in a patient with Hashimoto’s thyroiditis: case report. Thyroid 14: 631, 2004.

    Article  PubMed  Google Scholar 

  14. Krawitt EL. Histopatology of autoimmune hepatitis, primary cirrhosis and primary schlerosing cholangitis. In: Autoimmune Liver disease. Elsevier Publishing Company, 1998, 2nd ed.

  15. Le Moli R, Baldeschi L, Saeed P, Regensburg N, Mourits MP, Wiersinga WM. Determinants of liver damage associated with intravenous methylprednisolone pulse therapy in Graves’ ophthalmopathy. Thyroid 17: 357, 2007.

    Article  PubMed  Google Scholar 

  16. Lesnicar G. A prospective study of viral hepatitis A and the question of chronicity. Hepatogastroenterology 35: 69, 1988

    CAS  PubMed  Google Scholar 

  17. Stravitz RT, Sanyal AJ. Drug-induced steatohepatitis. Clin Liver Dis 7: 435, 2003.

    Article  PubMed  Google Scholar 

  18. Dalekos GN, Zachou K, Liaskos C, Gatselis N. Autoantibodies and defined target autoantigens in autoimmune hepatitis: an overview. Eur J Intern Med 13: 293, 2002.

    Article  CAS  PubMed  Google Scholar 

  19. Obermayer-Straub P, Strassberg CC, Manns MP. Autoimmune hepatitis. J Hepatol 32 (1 Suppl): 181, 2000.

    Article  CAS  PubMed  Google Scholar 

  20. Kahaly GJ, Pitz S, Hommel G, Dittmar M. Randomized, single blind trial of intravenous versus oral steroid monotherapy in Graves’ orbitopathy. J Clin Endocrinol Metab 90: 5234, 2005.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dipartimento di Endocrinologia e Metabolismo, Ospedale Cisanello, Via Paradisa 2, 56124, Pisa, Italia

    Maria Antonietta Altea, Eleonora Sisti, Aldo Pinchera, Claudio Marcocci &  Michele Marinò

Authors
  1. Maria Antonietta Altea
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eleonora Sisti
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Aldo Pinchera
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Claudio Marcocci
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michele Marinò
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michele Marinò.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Altea, M.A., Sisti, E., Pinchera, A. et al. Epatopatia e glucocorticoidi nella oftalmopatia basedowiana: un limite alla terapia?. L’Endocrinologo 9, 48–53 (2008). https://doi.org/10.1007/BF03344608

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03344608

Search

Navigation