Thyroid Associated Ophthalmopathy with Ocular Myasthenia in Primary Hypothyroidism
A 62-year-female presented with bilateral proptosis and 1 year episodic eye pain, grittiness, redness, watering and intermittent diplopia for 6 months, and drooping of right eye lid for 2 months (Figure 1). She had a firm WHO grade-1b goiter, exopthalmos (26 mm and 23 mm in left and right eye respectively, Hertel exopthalmometer), clinical activity score of 1/6, without any evidence of bulbar, neck muscles and limb weakness.
Eckstein AK, Lösch C, Glowacka D, Schott M, Mann K, Esser J, Morgenthaler NG. Euthyroid and primarily hypothyroid patients develop milder and significantly more asymmetrical Graves’ ophthalmopathy. Br J Ophthalmol.2009;93:1052-6.
Drachman D. Myasthenia gravis and other diseases of neuromuscular junction. In: Fauci A, Braunwald E, Kasper D, Hauser L. Harrison’s Principles of Internal Medicine. 17th Edition Volume-2, McGraw Hill. 2008; 2675.
Zouvelou V, Potagas C, Karandreas N, Rentzos M, Papadopoulou M, Zis VP, Vassilopoulos D. Concurrent presentation of ocular myasthenia and euthyroid Graves ophthalmopathy: A diagnostic challenge. J Clin Neurosci. 2008;15:719-20.
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