Isolated primary amyloidosis of the inferior rectus muscle mimicking Graves’ orbitopathy
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , |
Tipo de documento: | Relatório |
Idioma: | eng |
Título da fonte: | Einstein (São Paulo) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082016000400553 |
Resumo: | ABSTRACT The diagnosis of Graves’ orbitopathy is usually straightforward. However, orbital diseases that mimick some clinical signs of Graves’ orbitopathy may cause diagnostic confusion, particularly when associated to some form of thyroid dysfunction. This report describes the rare occurrence of localized inferior rectus muscle amyloidosis in a patient with autoimmune hypothyroidism, who was misdiagnosed as Graves’ orbitopathy. A 48-year-old man complained of painless progressive proptosis on the left side and intermittent vertical diplopia for 6 months. The diagnosis of Graves’ orbitopathy was entertained after magnetic resonance imaging revealing a markedly enlarged, tendon-sparing inferior rectus enlargement on the left side, and an autoimmune hypothyroidism was disclosed on systemic medical workup. After no clinical improvement with treatment, the patient was referred to an ophthalmologist and further investigation was performed. The presence of calcification in the inferior rectus muscle on computed tomography, associated with the clinical findings led to a diagnostic biopsy, which revealed amyloid deposition. This report emphasizes that a careful evaluation of atypical forms of Graves’ orbitopathy may be crucial and should include, yet with rare occurrence, amyloidosis in its differential diagnosis. |
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Isolated primary amyloidosis of the inferior rectus muscle mimicking Graves’ orbitopathyGraves disease/diagnosisOrbital diseasesOculomotor muscles/physiopathologyAmyloidosisTomography, x-ray computedCase reportsABSTRACT The diagnosis of Graves’ orbitopathy is usually straightforward. However, orbital diseases that mimick some clinical signs of Graves’ orbitopathy may cause diagnostic confusion, particularly when associated to some form of thyroid dysfunction. This report describes the rare occurrence of localized inferior rectus muscle amyloidosis in a patient with autoimmune hypothyroidism, who was misdiagnosed as Graves’ orbitopathy. A 48-year-old man complained of painless progressive proptosis on the left side and intermittent vertical diplopia for 6 months. The diagnosis of Graves’ orbitopathy was entertained after magnetic resonance imaging revealing a markedly enlarged, tendon-sparing inferior rectus enlargement on the left side, and an autoimmune hypothyroidism was disclosed on systemic medical workup. After no clinical improvement with treatment, the patient was referred to an ophthalmologist and further investigation was performed. The presence of calcification in the inferior rectus muscle on computed tomography, associated with the clinical findings led to a diagnostic biopsy, which revealed amyloid deposition. This report emphasizes that a careful evaluation of atypical forms of Graves’ orbitopathy may be crucial and should include, yet with rare occurrence, amyloidosis in its differential diagnosis.Instituto Israelita de Ensino e Pesquisa Albert Einstein2016-12-01info:eu-repo/semantics/reportinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082016000400553einstein (São Paulo) v.14 n.4 2016reponame:Einstein (São Paulo)instname:Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE)instacron:IIEPAE10.1590/s1679-45082016rc3744info:eu-repo/semantics/openAccessMonteiro,Mário Luiz RibeiroGonçalves,Allan Christian PieroniBezerra,Alanna Mara Pinheiro Sobreiraeng2017-01-05T00:00:00Zoai:scielo:S1679-45082016000400553Revistahttps://journal.einstein.br/pt-br/ONGhttps://old.scielo.br/oai/scielo-oai.php||revista@einstein.br2317-63851679-4508opendoar:2017-01-05T00:00Einstein (São Paulo) - Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE)false |
dc.title.none.fl_str_mv |
Isolated primary amyloidosis of the inferior rectus muscle mimicking Graves’ orbitopathy |
title |
Isolated primary amyloidosis of the inferior rectus muscle mimicking Graves’ orbitopathy |
spellingShingle |
Isolated primary amyloidosis of the inferior rectus muscle mimicking Graves’ orbitopathy Monteiro,Mário Luiz Ribeiro Graves disease/diagnosis Orbital diseases Oculomotor muscles/physiopathology Amyloidosis Tomography, x-ray computed Case reports |
title_short |
Isolated primary amyloidosis of the inferior rectus muscle mimicking Graves’ orbitopathy |
title_full |
Isolated primary amyloidosis of the inferior rectus muscle mimicking Graves’ orbitopathy |
title_fullStr |
Isolated primary amyloidosis of the inferior rectus muscle mimicking Graves’ orbitopathy |
title_full_unstemmed |
Isolated primary amyloidosis of the inferior rectus muscle mimicking Graves’ orbitopathy |
title_sort |
Isolated primary amyloidosis of the inferior rectus muscle mimicking Graves’ orbitopathy |
author |
Monteiro,Mário Luiz Ribeiro |
author_facet |
Monteiro,Mário Luiz Ribeiro Gonçalves,Allan Christian Pieroni Bezerra,Alanna Mara Pinheiro Sobreira |
author_role |
author |
author2 |
Gonçalves,Allan Christian Pieroni Bezerra,Alanna Mara Pinheiro Sobreira |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Monteiro,Mário Luiz Ribeiro Gonçalves,Allan Christian Pieroni Bezerra,Alanna Mara Pinheiro Sobreira |
dc.subject.por.fl_str_mv |
Graves disease/diagnosis Orbital diseases Oculomotor muscles/physiopathology Amyloidosis Tomography, x-ray computed Case reports |
topic |
Graves disease/diagnosis Orbital diseases Oculomotor muscles/physiopathology Amyloidosis Tomography, x-ray computed Case reports |
description |
ABSTRACT The diagnosis of Graves’ orbitopathy is usually straightforward. However, orbital diseases that mimick some clinical signs of Graves’ orbitopathy may cause diagnostic confusion, particularly when associated to some form of thyroid dysfunction. This report describes the rare occurrence of localized inferior rectus muscle amyloidosis in a patient with autoimmune hypothyroidism, who was misdiagnosed as Graves’ orbitopathy. A 48-year-old man complained of painless progressive proptosis on the left side and intermittent vertical diplopia for 6 months. The diagnosis of Graves’ orbitopathy was entertained after magnetic resonance imaging revealing a markedly enlarged, tendon-sparing inferior rectus enlargement on the left side, and an autoimmune hypothyroidism was disclosed on systemic medical workup. After no clinical improvement with treatment, the patient was referred to an ophthalmologist and further investigation was performed. The presence of calcification in the inferior rectus muscle on computed tomography, associated with the clinical findings led to a diagnostic biopsy, which revealed amyloid deposition. This report emphasizes that a careful evaluation of atypical forms of Graves’ orbitopathy may be crucial and should include, yet with rare occurrence, amyloidosis in its differential diagnosis. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-12-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/report |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
report |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082016000400553 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082016000400553 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/s1679-45082016rc3744 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Instituto Israelita de Ensino e Pesquisa Albert Einstein |
publisher.none.fl_str_mv |
Instituto Israelita de Ensino e Pesquisa Albert Einstein |
dc.source.none.fl_str_mv |
einstein (São Paulo) v.14 n.4 2016 reponame:Einstein (São Paulo) instname:Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE) instacron:IIEPAE |
instname_str |
Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE) |
instacron_str |
IIEPAE |
institution |
IIEPAE |
reponame_str |
Einstein (São Paulo) |
collection |
Einstein (São Paulo) |
repository.name.fl_str_mv |
Einstein (São Paulo) - Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE) |
repository.mail.fl_str_mv |
||revista@einstein.br |
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1752129908712144896 |