Graves' hyperthyroidism and ophthalmopathy associated with pemphigus vulgaris: onset of thyroid autoimmune disease during chronic low-dose glucocorticoid therapy

Journal of Endocrinological Investigation
L BartalenaE Martino

Abstract

A 38-year-old caucasian woman developed typical Graves' hyperthyroidism and ophthalmopathy while being chronically treated for pemphigus vulgaris with low doses of glucocorticoids capable of effectively controlling skin disease. HLA typing showed positivity for DR3 and DR4, suggesting a genetic susceptibility for both Graves' disease and pemphigus vulgaris. The apparent contradiction whereby thyroid autoimmune disease flared up during therapy with glucocorticoids, known for their immunosuppressive effects, may be related to the dose of steroids. It is possible that high doses of glucocorticoids, commonly employed in the treatment of severe Graves' ophthalmopathy, might indeed suppress the disease, whereas the low doses used in this patient might precipitate or aggravate it.

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Citations

Oct 14, 2014·Case Reports in Endocrinology·Mostafa AlfishawyAhmed Daoud
Dec 10, 1999·Survey of Ophthalmology·B LaceyJ Rootman
Feb 2, 2010·Journal of the American Academy of Dermatology·Maryam DaneshpazhoohCheyda Chams-Davatchi
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May 8, 2003·Journal of the American Academy of Dermatology·Julia AiWarren R Heymann

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