External ophthalmoplegia associated with Hashimoto's thyroiditis and recovered on corticosteroid treatment.

Abstract

Five-year follow-up of a young male patient is presented. Total external ophthalmoplegia developed 1 week after an upper respiratory tract infection. After 3 years of the course, hyperthyreosis and clinical signs of thyroid-associated ophthalmopathy occurred. Hashimoto's thyroiditis and ultrastructural signs of mitochondrial damage of striated muscle were found by histological investigations. The paresis of the external ocular muscles recovered after long-term corticosteroid treatment. On the basis of clinical symptoms and histological results, the authors supposed that an immunological reaction had caused mitochondrial damage in the striated muscles, which also resulted in thyroiditis. This case history points that autoimmune mechanism more frequently might participate in the pathogenesis of chronic external ophthalmoplegia, and the symptoms might precede organ-specific or perhaps systemic autoimmune disorders.

• Authors: István Gáti, Hajnalka Merkli, Endre Pál, Olof Danielsson
• Journal: The American journal of the medical sciences (Am J Med Sci) Vol. 344 Issue 2 Pg. 151-2 (Aug 2012) ISSN: 1538-2990 [Electronic] United States
• PMID: 22534671 (Publication Type: Case Reports, Journal Article)

Chemical References

• Glucocorticoids
• Methylprednisolone

Topics

• Glucocorticoids (therapeutic use)
• Hashimoto Disease (complications, drug therapy)
• Humans
• Male
• Methylprednisolone (therapeutic use)
• Ophthalmoplegia (drug therapy, etiology)
• Young Adult