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A Case-Based Guide to Clinical EndocrinologyImmunoglobulin G4 and Graves’ Orbitopathy

A Case-Based Guide to Clinical Endocrinology: Immunoglobulin G4 and Graves’ Orbitopathy [An interesting and novel case report describes a rare combination of Graves’ orbitopathy (GO) and elevated serum levels of immunoglobulin G4 (IgG4) which was associated with a severe clinical phenotype with compressive symptoms and signs of optic nerve neuropathy. High serum levels of stimulatory thyrotropin receptor autoantibodies were associated with both the clinical course of thyroid eye disease and the response to specific therapy. Urgent medical treatment and subsequent surgical bony decompression of the orbit led to clinical improvement and normalization of visual acuity. Measurement of serum IgG4 is recommended in severe cases of GO and/or in cases not responding to standard immunosuppressive treatment.] http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png

A Case-Based Guide to Clinical EndocrinologyImmunoglobulin G4 and Graves’ Orbitopathy

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Publisher
Springer International Publishing
Copyright
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022
ISBN
978-3-030-84366-3
Pages
61 –66
DOI
10.1007/978-3-030-84367-0_6
Publisher site
See Chapter on Publisher Site

Abstract

[An interesting and novel case report describes a rare combination of Graves’ orbitopathy (GO) and elevated serum levels of immunoglobulin G4 (IgG4) which was associated with a severe clinical phenotype with compressive symptoms and signs of optic nerve neuropathy. High serum levels of stimulatory thyrotropin receptor autoantibodies were associated with both the clinical course of thyroid eye disease and the response to specific therapy. Urgent medical treatment and subsequent surgical bony decompression of the orbit led to clinical improvement and normalization of visual acuity. Measurement of serum IgG4 is recommended in severe cases of GO and/or in cases not responding to standard immunosuppressive treatment.]

Published: Jan 4, 2022

Keywords: IgG4-related orbital disease; Graves’ orbitopathy; Orbital inflammation

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