A difficult diagnosis: severe Graves' ophthalmolopathy

BMJ Case Reports
Ivan Yeu Ming YipTristan Reuser

Abstract

An 81-year-old woman with atrial fibrillation, on warfarin, with known hyperthyroidism, was admitted to hospital following a fall with proptosis and severely restricted movements in her left eye. Medics initially thought the presentation was related to an intracranial pathology but through subsequent tests and examination, ophthalmologists diagnosed a severe case of thyroid eye disease with intense inflammation. The patient responded well to systemic steroid treatment. This case report highlights a severe rapidly progressing case of thyroid eye disease with diagnostic difficulties arising from multiple comorbidities in an elderly patient.

References

Jan 1, 1989·Ophthalmic Research·W M WiersingaL Koornneef
Dec 19, 2002·Thyroid : Official Journal of the American Thyroid Association·Wilmar M Wiersinga, Luigi Bartalena
Dec 13, 2003·Endocrine Reviews·Bellur S PrabhakarTerry J Smith
Sep 8, 2007·Thyroid : Official Journal of the American Thyroid Association·Basil Rapoport, Sandra M McLachlan

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