Multipl skleroz ve oftalmik graves: Koinsidans mı, birliktelik mi?
Küçük Resim Yok
Tarih
2004
Yazarlar
Dergi Başlığı
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Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
İmmunolojik hastalıklarin belirleyici bir özelligi de onların birbirleriyle birliktelikleridir.Multipl Skleroz (MS) patogenezinde, ekzojen faktorler, genetik olarak belirleyici karakterler ve immunolojik bozuklukların ilişkili olduğu gorunmektedir. Son iki durumdan dolayi, MS genellikle immunolojik bir hastalik olarak düşünümektedir. Graves hastalığiyla oftalmopati birlikteliginin doğası,daima süregelen bir anlaşmazlik sahasi olmuştur.Bu hastalıklarin birlikteligini destekleyen deliller vardir.Oftalmopatili hastalar, hipertiroid, hipotiroid veya otiroid olabilirler.Ekzoftalmusa yol acan infiltratif oftalmopati bazi durumlarda hipertiroidizm ile birlikte gorulur.Oftalmopati hipertiroidizmin baslangicindan once veya daha sonra ortaya cikabilir.Oftalmopatinin Graves hipertiroidizminden ayrilabilen farkli bir otoimmun hastalik olduğunun kanitları vardir. Bu bildiride MS ve Oftalmik Graves (OG) birlikteliği düşündüğümüz iki bayan hasta sunmaktayiz. 1. olgumuz-da asimetrik ekzoftalmus ve kranial MR'da periventrikuler demyelinize alanlar, 2. olgumuzda asimetrik ekzoftalmus ve görme keskinliğinde azalma bulguları mevcut idi. Her iki olgu da otiroid idi. Optik sinirde ve ekstraokuler kaslarda ayni anda ödem ve inflamasyon bulguları vardi. MS ve OG birlikteligi gösteren olgular, progressif ekzoftalmus, optik atrofi, görme kaybina kadar giden bir klinik seyir gösterebilmektedir. Bu nedenle burada erken tani ve tedavinin onemi vurgulanmaktadir. Dolayisiyla ekzoftalmus nedenleri arasinda, özellikle gene erişkin yas grubunda MS ve OG birlikteligi de akla getirilmelidir.
A characteristic feature of immunologic diseases is their association with each other. In the pathogenesis of multiple sclerosis (MS), an exogenous factor, a genetically determined disposition and immunologic disturbances seem to be relevant. Because of the latter 2 conditions, MS is mostly thought of as an immunologic disease. The nature of the association of ophthalmopathy with Graves' disease has been an area of ongoing controversy. There is evidence supporting an association of these disorders. Patients with ophthalmopathy may be hyperthyroid, hypothyroid, or euthyroid. Infiltratif ophthalmopathy that causes exophthalmus in some conditions is seen together with hyperthyroidism. Ophthalmopathy may occur before or after initial of hyperthyroidism. There is evidence that the ophthalmopathy is a distinct autoimmune disorder separable from Graves' hyperthyroidism. In this report we are presenting two female patients with MS together with Ophthalmic Graves (OG). In the first case asymmetric exophthalmus and periventriculer demyelinizated areas in ventral MRI, in the second case asymmetric exophthalmus and decrease in visual acuity were present.Both cases were euthyroid. In the optic nerve and extraocular muscles there was edema and inflammation at the same time.ln the cases MS with OG, progressive exophthalmus and optic atrophy may happen in a clinical course arriving to visual loss at the end. Thus, here, the essential importance of the early diagnosis and treatment is emphasized. Reasonably, among the causes of exophthalmus, especially in the young adulthood, MS and OG association have to be recognized.
A characteristic feature of immunologic diseases is their association with each other. In the pathogenesis of multiple sclerosis (MS), an exogenous factor, a genetically determined disposition and immunologic disturbances seem to be relevant. Because of the latter 2 conditions, MS is mostly thought of as an immunologic disease. The nature of the association of ophthalmopathy with Graves' disease has been an area of ongoing controversy. There is evidence supporting an association of these disorders. Patients with ophthalmopathy may be hyperthyroid, hypothyroid, or euthyroid. Infiltratif ophthalmopathy that causes exophthalmus in some conditions is seen together with hyperthyroidism. Ophthalmopathy may occur before or after initial of hyperthyroidism. There is evidence that the ophthalmopathy is a distinct autoimmune disorder separable from Graves' hyperthyroidism. In this report we are presenting two female patients with MS together with Ophthalmic Graves (OG). In the first case asymmetric exophthalmus and periventriculer demyelinizated areas in ventral MRI, in the second case asymmetric exophthalmus and decrease in visual acuity were present.Both cases were euthyroid. In the optic nerve and extraocular muscles there was edema and inflammation at the same time.ln the cases MS with OG, progressive exophthalmus and optic atrophy may happen in a clinical course arriving to visual loss at the end. Thus, here, the essential importance of the early diagnosis and treatment is emphasized. Reasonably, among the causes of exophthalmus, especially in the young adulthood, MS and OG association have to be recognized.
Açıklama
Anahtar Kelimeler
Endokrinoloji ve Metabolizma
Kaynak
Endokrinolojide Yönelişler
WoS Q Değeri
Scopus Q Değeri
Cilt
13
Sayı
1
