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Graves' Orbitopathy
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Страница 1
Graves’ Orbitopathy A Multidisciplinary Approach – Questions and Answers
Graves’ Orbitopathy A Multidisciplinary Approach – Questions and Answers
Страница 4
Contents
Preface to the Third, Revised and Expanded Edition
Страница 7
Страница 8
Clinical Manifestations
What Are the Common Signs and Symptoms of Early Graves’ Orbitopathy?
What Are Other Signs and Symptoms of Graves’ Orbitopathy?
What Signs Should Question the Diagnosis of Graves’ Orbitopathy?
Are There Racial Differences in How Graves’ Orbitopathy Manifests?
Is the Presentation of Graves’ Orbitopathy Different in Older Compared to Younger Patients?
Why Can the Clinical Presentation of Graves’ Orbitopathy Be So Variable?
Can You Give Me a Short Mechanistic Explanation for All These Clinical Manifestations?
What Do the Terms “Activity” and “Severity” Denote?
Why Is It Important to Distinguish Activity and Severity when Evaluating Patients?
What Signs and Symptoms Are Valuable for Assessing Activity?
How Are These Signs Assessed?
Eyelid Swelling
Eyelid Erythema
Conjunctival Redness
Chemosis (Conjunctival Oedema)
Inflammation of the Caruncle or Plica
How Reproducible Are These Assessments?
What Value Does the “Clinical Activity Score” Have?
Do Patients without Signs of Activity Ever Have Active Disease?
What Should I Do if I Am Not Sure whether the Disease Is Active?
Are There Any Other Ways to Evaluate Activity other than Clinical Examination?
When Should These Other Methods for Assessing Activity Be Used in Routine Clinical Practice?
What Signs Are Helpful for Assessing Severity?
What Value Does the Mnemonic “NOSPECS” Have?
How Are Signs of Severity Assessed?
How Reproducible Are These Assessments?
How Is Severity Best Classified?
How Do You Decide whether a Patient Has Dysthyroid Optic Neuropathy?
Can Dysthyroid Optic Neuropathy Ever Be Present with Normal Vision?
Are Some Patients at Particular Risk?
What Other Assessments Are Useful in Evaluating Possible Dysthyroid Optic Neuropathy?
Should These Tests Be Performed in All Patients at Every Assessment?
Are There Any Other Assessment Systems in Common Use?
References
Страница 44
Orbit-Thyroid Relationship
Should This Condition Always Be Called Graves’ Orbitopathy?
Is Graves’ Orbitopathy Exclusively Occurring in Patients with Graves’ Hyperthyroidism?
Do All Patients with Graves’ Hyperthyroidism Have Graves’ Orbitopathy?
Are There Any Relationships between Hyperthyroidism, Hypothyroidism, and Graves’ Orbitopathy?
Is Graves’ Orbitopathy Related to Thyroid Autoimmunity?
Are There Other Extrathyroidal Manifestations of Graves’ Disease apart from Graves’ Orbitopathy?
References
Страница 53
Epidemiology
What Is the Estimated Incidence and Prevalence of Graves’ Orbitopathy?
Has the Occurrence of Graves’ Orbitopathy Changed over the Last Few Decades?
Is the Age and Sex Distribution of Graves’ Orbitopathy Similar to That of Graves’ Hyperthyroidism?
Are There Ethnic Differences?
What Are the Risk Factors for the Occurrence of Graves’ Orbitopathy?
Can Particular Drugs Trigger or Modify Graves’ Orbitopathy and Its Course?
Is Tobacco Bad for Graves’ Orbitopathy?
Has Nutrition an Effect on Graves’ Orbitopathy?
Does Total Thyroidectomy for Other Diseases than Graves’ Disease Preclude the Development of Graves’ Orbitopathy?
References
Страница 65
Pathogenesis
What Are the Pathological Changes in Orbital Tissue in Graves’ Orbitopathy?
Early Inflammatory Changes
De novo Adipogenesis
Increased Production of Glycosaminoglycans
How Do the Pathological Changes Give Rise to the Clinical Manifestations?
What Triggers Graves’ Orbitopathy?
Is Graves’ Orbitopathy Triggered by an Autoimmune Phenomenon? If So, What Is the Nature of the Autoantigen?
Why Is the Orbit Special and a Target for Thyroid Autoimmunity?
What Kind of Immune Reactions Take Place within the Orbit?
Does Thyroid-Stimulating Hormone Receptor Activation and/or Autoreactivity to Thyroid-Stimulating Hormone Receptor Play a Role in the Onset or Development of Graves’ Orbitopathy?
Is There a Familial Predisposition or a Specific Genetic Background for Graves’ Orbitopathy?
How Do Environmental Factors Increase the Risk and Severity of Graves’ Orbitopathy?
How May These Observations and Current Understanding Lead to More Effective Treatment of Graves’ Orbitopathy?
References
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