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Etanercept in the treatment of Graves' ophthalmopathy with primary hypothyroidism and rheumatoid arthritis.
Central European Journal of Immunology ( IF 1.3 ) Pub Date : 2020-01-20 , DOI: 10.5114/ceji.2019.92803
Olivera Boskovic 1 , Sanja Medenica 1, 2 , Nemanja Radojevic 2, 3 , Milos Zarkovic 4
Affiliation  

Graves' ophthalmopathy (GO) is an autoimmune disease affecting ocular and orbital tissues. Overproduction of tumor necrosis factor α (TNF-α) in rheumatoid arthritis (RA) and GO has destructive consequences. The subject of this paper is a case of a female patient initially diagnosed with primary hypothyroidism substitution with levothyroxine, and subsequent diagnosis of RA with insufficient therapeutic efficacy of a standard medication. Three years later, the patient presented symptoms and signs of GO. Etanercept was administrated for RA, and after four months, an improvement of the eye symptoms and reduced exophthalmos were observed and confirmed using visual methods. Graves' ophthalmopathy association with primary hypothyroidism is uncommon. The treatment of RA using etanercept led to clinical improvement of GO symptoms, which indicates that RA and GO may share similar pathogenic features. The paper suggests that etanercept may suppress the symptoms and clinical signs of GO. However, controlled trials are needed to further evaluate the effect of TNF-α inhibitors, particularly etanercept, and to compare its side effects with the current options for medical treatment.

中文翻译:

依那西普治疗Graves眼病伴原发性甲状腺功能减退症和类风湿关节炎。

Graves眼病(GO)是一种影响眼和眼组织的自身免疫性疾病。类风湿关节炎(RA)和GO中肿瘤坏死因子α(TNF-α)的过量产生具有破坏性后果。本文的主题为一例女性患者,最初被诊断为左甲状腺素原发性甲状腺功能减退症,随后被诊断为标准药物治疗功效不足的RA。三年后,患者出现GO的症状和体征。依那西普(Etanercept)用于类风湿性关节炎(RA),四个月后,观察到并通过视觉方法确认了眼部症状的改善和眼球突出的减少。Graves眼病与原发性甲状腺功能减退症的关联并不常见。使用依那西普治疗RA可改善GO症状的临床表现,这表明RA和GO可能具有相似的致病特征。本文提示依那西普可以抑制GO的症状和临床症状。但是,需要进行对照试验以进一步评估TNF-α抑制剂(尤其是依那西普)的作用,并将其副作用与当前的医疗选择进行比较。
更新日期:2020-01-20
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