External Ophthalmoplegia Associated With Hashimoto’s Thyroiditis and Recovered on Corticosteroid Treatment

• Published in: The American journal of the medical sciences Vol. 344; no. 2; pp. 151 - 152
• Main Authors: Gáti, István, MD, PhD, Danielsson, Olof, MD, Merkli, Hajnalka, MD, Pál, Endre, MD, PhD
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Elsevier Inc 01-08-2012; Lippincott Williams & Wilkins
• Subjects: Biological and medical sciences; Corticosteroid treatment; Endocrinopathies; External ophthalmoplegia; General aspects; Glucocorticoids - therapeutic use; Hashimoto Disease - complications; Hashimoto Disease - drug therapy; Hashimotos thyroiditis; Hashimoto’s thyroiditis; Humans; Internal Medicine; Male; Medical sciences; MEDICIN; MEDICINE; Methylprednisolone - therapeutic use; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Oculomotor disorders; Ophthalmology; Ophthalmoplegia - drug therapy; Ophthalmoplegia - etiology; Thyroid. Thyroid axis (diseases); Young Adult; Hashimoto’s thyroiditis; External ophthalmoplegia; Corticosteroid treatment; Endocrinopathy; Immunopathology; Corticosteroid; Thyroid diseases; Autoimmune disease; Hashimoto's thyroiditis; Medicine; Eye disease; Association; Treatment; Hashimoto thyroiditis; External; Ophthalmoplegia; Oculomotor syndrome
• ISSN: 0002-9629; 1538-2990; 1538-2990
• DOI: 10.1097/MAJ.0b013e31824d4d93

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.