Skip to main content
NCBI home page
British Medical Journal logoLink to British Medical Journal
. 1979 Feb 10;1(6160):374–376. doi: 10.1136/bmj.1.6160.374

Successful treatment of exophthalmos and pretibial myxoedema with plasmapheresis.

P Dandona, N J Marshall, S P Bidey, A Nathan, C W Havard
PMCID: PMC1597937  PMID: 581653

Abstract

A patient with Graves's disease with acute progressive exophthalmos and pretibial myxoedema was treated twice with plasmapheresis. Two weeks after the first treatment the symptoms recurred, but 20 weeks after the second treatment the exophthalmos was much improved and the pretibial myxoedema had disappeared. Analysis of sequential serum IgG concentrations and the thyroid-stimulating immunoglobulin index suggested that the two conditions were caused by specific IgGs. The results suggest that plasmapheresis has a useful place in the treatment of acute and rapidly progressive ophthalmopathy and pretibial myxoedema in patients with Graves's disease.

Full text

PDF
374

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Branda R. F., Moldow C. F., McCullough J. J., Jacob H. S. Plasma exchange in the treatment of immune disease. Transfusion. 1975 Nov-Dec;15(6):570–576. doi: 10.1046/j.1537-2995.1975.15676082232.x. [DOI] [PubMed] [Google Scholar]
  2. Brown R. S., Jackson I. M., Pohl S. L., Reichlin S. Do thyroid-stimulating immunoglobulins cause non-toxic and toxic multinodular goitre? Lancet. 1978 Apr 29;1(8070):904–906. doi: 10.1016/s0140-6736(78)90682-7. [DOI] [PubMed] [Google Scholar]
  3. Bystryn J. C., Graf M. W., Uhr J. W. Regulation of antibody formation by serum antibody. II. Removal of specific antibody by means of exchange transfusion. J Exp Med. 1970 Dec 1;132(6):1279–1287. doi: 10.1084/jem.132.6.1279. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Dau P. C., Lindstrom J. M., Cassel C. K., Denys E. H., Shev E. E., Spitler L. E. Plasmapheresis and immunosuppressive drug therapy in myasthenia gravis. N Engl J Med. 1977 Nov 24;297(21):1134–1140. doi: 10.1056/NEJM197711242972102. [DOI] [PubMed] [Google Scholar]
  5. Gill D. L., Marshall N. J., Ekins R. P. Binding of thyrotropin to receptors in fat tissue. Mol Cell Endocrinol. 1978 Feb-Mar;10(1):89–102. doi: 10.1016/0303-7207(78)90062-x. [DOI] [PubMed] [Google Scholar]
  6. Lockwood C. M., Rees A. J., Pearson T. A., Evans D. J., Peters D. K., Wilson C. B. Immunosuppression and plasma-exchange in the treatment of Goodpasture's syndrome. Lancet. 1976 Apr 3;1(7962):711–715. doi: 10.1016/s0140-6736(76)93089-0. [DOI] [PubMed] [Google Scholar]
  7. Mukhtar E. D., Smith B. R., Pyle G. A., Hall R., Vice P. Relation of thyroid-stimulating immunoglobulins to thyroid function and effects of surgery, radioiodine, and antithyroid drugs. Lancet. 1975 Mar 29;1(7909):713–715. doi: 10.1016/s0140-6736(75)91629-3. [DOI] [PubMed] [Google Scholar]
  8. Pinching A. J., Peters D. K. Remission of myasthenia gravis following plasma-exchange. Lancet. 1976 Dec 25;2(8000):1373–1376. doi: 10.1016/s0140-6736(76)91917-6. [DOI] [PubMed] [Google Scholar]
  9. Schleusener H., Finke R., Kotulla P., Wenzel K. W., Meinhold H., Roedler H. D. Determination of thyroid stimulating immunoglobulins (TSI) during the course of Graves' disease. A reliable indicator for remission and persistence of this disease? J Endocrinol Invest. 1978 Apr;1(2):155–161. doi: 10.1007/BF03350364. [DOI] [PubMed] [Google Scholar]
  10. Winand R. J., Kohn L. D. The binding of ( 3 H)thyrotropin and an 3 H-labeled exophthalmogenic factor by plasma membranes of retro-orbital tissue. Proc Natl Acad Sci U S A. 1972 Jul;69(7):1711–1715. doi: 10.1073/pnas.69.7.1711. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES