TITLE:
Basedowian Orbitopathy without Thyreotoxicosis: A Case Report from Sikasso Hospital
AUTHORS:
Cheickna Nomoko, Adama Dembele, Moro Sidibe, Karim Diarra, Moussa Sidibé, Niamé Touré, Moussa Abdou Touré, Oulematou Soucko, Ousmane Fané, Daouda Goita, Oumar Diallo, Djonny Jonas Dembele, Mamadou Adama Togo, Kadiatou Ba Koita, Abdoulaye Nouhoum Coulibaly, Cheick Fantamady Tounkara, Nouhoum Touré, Abdoulaye Konaté, Abdoulaye Napo, Nana Kadidia Fofana
KEYWORDS:
Euthyroidism, Basedowian Orbitopathy, Orbital-Cerebral, MRI, Corticosteroid Therapy
JOURNAL NAME:
Open Journal of Ophthalmology,
Vol.13 No.3,
June
25,
2023
ABSTRACT: Basedowian orbitopathy is an autoimmune disease representing the most frequent extra-thyroidal manifestation. Its pathophysiology is imperfectly elucidated and is the result of cross-reactivity between thyroid antigens and orbital tissue. It is most frequently seen in the context of hyperthyroidism (basedow’s disease or Graves’ disease), sometimes hypothyroidism (Hashimoto’s thyroiditis), or euthyroidism. Diagnosis is often straightforward, but management remains difficult. The introduction of simple medical treatment exposes the patient to the risk of recurrence. In Sikasso, there have been few studies of Graves’ disease. The aim of this study was to describe the clinical, therapeutic and evolutionary features of Graves’ disease in Sikasso Hospital. The patient was a 35-year-old woman with no previous history of Graves’ disease and no history of alcohol or tobacco intoxication, consulting for bilateral exophthalmos with moderate pain for 1 year. Endocrine tests were normal (euthyroidism), as was orbital-cerebral MRI, which revealed stage II exophthalmos with no sellar or supra-saltar abnormalities. The main complication was exposure to keratitis. Our patient was treated with corticosteroids. The evolution was favorable under treatment, with no recurrence after one year’s follow-up. Graves’ disease is the most common cause of hyperthyroidism, but this should not obscure the diagnosis of euthyroidism, as demonstrated in this case report. Exophthalmos remains the main ophthalmological clinical manifestation.