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Thyroid Diseases pp 451–488Cite as

Graves’ Ophthalmopathy

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Part of the book series: Endocrinology ((ENDOCR))

Abstract

Thyroid-associated ophthalmopathy aka Graves’ orbitopathy (GO), represents the periocular component of Graves’ disease (GD), for which safe and effective therapies remain elusive. The central pathogenic event in GD is loss of immune tolerance to the thyrotropin receptor (TSHR) and generation of activating anti-TSHR antibodies. Recent evidence suggests that TSHR might collaborate with other proteins, such as the insulin-like growth factor-I receptor in the pathogenesis of GO. In this chapter we have attempted to review the most most recent insights into disease mechanisms underlying GO, strategies for evaluating patients, and currently available therapeutic strategies and those remedies that are in development.

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Abbreviations

AKT:

Protein kinase B

Arg:

Arginine

CAS:

Clinical activity score

CD:

Cluster of differentiation

CTLA-4:

Cytotoxic T-lymphocyte-associated protein 4, also known as CD152

DON:

Dysthyroid optic neuropathy

FRAP:

FK506-binding protein 12-rapamycin-associated protein

GD:

Graves’ disease

GO:

Graves’ orbitopathy, also known as thyroid-associated ophthalmopathy

HA:

Hyaluronan

HLA-DRβ:

Human leukocyte antigen DRβ

IGF-IR:

Insulin-like growth factor-I receptor

IL:

Interleukin

mTOR:

Mechanistic target of rapamycin

OR:

Orbital radiotherapy

PGE2:

Prostaglandin E2

PGHS-2:

Prostaglandin endoperoxide H synthase-2

PTPN22:

Protein tyrosine phosphatase, non-receptor type 22

QoL:

Quality of life

RANTES:

Regulated on activation, normal T cell expressed and secreted

TGF-beta:

Transforming growth factor beta

THYPRO:

Thyroid patient reported outcome

TNF:

Tumor necrosis factor

TSHR Ab:

Thyrotropin receptor antibodies

TSHR:

Thyrotropin receptor

TSI:

Stimulating TSHR Ab

UDP:

Uridine diphosphate

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Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy

    Claudio Marcocci

  2. Department of Ophthalmology and Visual Sciences Kellogg Eye Center and Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Brehm Tower, 1000 Wall Street, Ann Arbor, MI, 48105, USA

    Terry J. Smith

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  1. Claudio Marcocci
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  2. Terry J. Smith
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Correspondence to Terry J. Smith .

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Editors and Affiliations

  1. Department of Endocrinology, University of Pisa, Pisa, Italy

    Paolo Vitti

  2. Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark

    Laszlo Hegedüs

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Marcocci, C., Smith, T.J. (2018). Graves’ Ophthalmopathy. In: Vitti, P., Hegedüs, L. (eds) Thyroid Diseases. Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-319-45013-1_16

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  • DOI: https://doi.org/10.1007/978-3-319-45013-1_16

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