The diagnosis of Graves' orbitopathy is usually straightforward. However, orbital diseases that mimick some clinical signs of Graves' orbitopathy may cause diagnostic confusion, particularly when associated to some form of thyroid dysfunction. This report describes the rare occurrence of localized inferior rectus muscle amyloidosis in a patient with autoimmune hypothyroidism, who was misdiagnosed as Graves' orbitopathy. A year-old man complained of painless progressive proptosis on the left side and intermittent vertical diplopia for 6 months. The diagnosis of Graves' orbitopathy was entertained after magnetic resonance imaging revealing a markedly enlarged, tendon-sparing inferior rectus enlargement on the left side, and an autoimmune hypothyroidism was disclosed on systemic medical workup. After no clinical improvement with treatment, the patient was referred to an ophthalmologist and further investigation was performed.
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Mueller OS. Kyle RA. Amyloidosis: a convoluted story. Br J Haematol. Rev Bras Reumatol. Significance of SAA1. Merline G, Bellotti V. Molecular mechanisms of amyloidosis.
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Arthritis Rheum. Rapid and complete resolution of proteinuria due to renal amyloidosis in a patient with rheumatoid arthritis treated with infliximab. All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License. Services on Demand Journal. Av Brigadeiro Luiz Antonio, - Cj How to cite this article.
Isolated Primary Amyloidosis of the Inferior Rectus Muscle Mimicking Graves' Orbitopathy
Mueller OS. Kyle RA. Amyloidosis: a convoluted story. Br J Haematol. Rev Bras Reumatol.
Identificou-se que raramente ocorre em pacientes abaixo dos 70 anos. Diante disso propomos um fluxograma norteador para o manejo destes pacientes Figuras 2 e 3. TTR: transtirretina. A medida da espessura do septo interventricular pode sugerir o tipo de amiloidose presente no paciente, sendo frequentemente maior nos casos de amiloidose por TTR do que a forma AL, podendo em muitos casos ser superior a 20 mm. Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med.
Definition of organ involvement and treatment response in immunoglobulin light chain amyloidosis AL : a consensus opinion from the 10th International Symposium on Amyloid and Amyloidosis, Tours, France, April Am J Hematol. Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: a report of the International Myeloma Working Group. Br J Haematol. MAG is also an author of several references cited in this monograph. DR has been reimbursed by Millennium Pharmaceuticals, Inc and Johnson and Johnson, the manufacturers of bortezomib, for attending several conferences, for speaking at educational meetings, and for consulting work.