Basedowian orbitopathy is an autoimmune disease representing the most frequent extra-thyroidal manifestation. Its pathophysiology is imperfectly elucidated and is the result of cross-reactivity between thyroid antigen...Basedowian orbitopathy is an autoimmune disease representing the most frequent extra-thyroidal manifestation. Its pathophysiology is imperfectly elucidated and is the result of cross-reactivity between thyroid antigens and orbital tissue. It is most frequently seen in the context of hyperthyroidism (basedow’s disease or Graves’ disease), sometimes hypothyroidism (Hashimoto’s thyroiditis), or euthyroidism. Diagnosis is often straightforward, but management remains difficult. The introduction of simple medical treatment exposes the patient to the risk of recurrence. In Sikasso, there have been few studies of Graves’ disease. The aim of this study was to describe the clinical, therapeutic and evolutionary features of Graves’ disease in Sikasso Hospital. The patient was a 35-year-old woman with no previous history of Graves’ disease and no history of alcohol or tobacco intoxication, consulting for bilateral exophthalmos with moderate pain for 1 year. Endocrine tests were normal (euthyroidism), as was orbital-cerebral MRI, which revealed stage II exophthalmos with no sellar or supra-saltar abnormalities. The main complication was exposure to keratitis. Our patient was treated with corticosteroids. The evolution was favorable under treatment, with no recurrence after one year’s follow-up. Graves’ disease is the most common cause of hyperthyroidism, but this should not obscure the diagnosis of euthyroidism, as demonstrated in this case report. Exophthalmos remains the main ophthalmological clinical manifestation.展开更多
Basedowian orbitopathy is an autoimmune disease representing the most frequent extra-thyroidal manifestation. Its pathophysiology is imperfectly elucidated and is the result of cross-reactivity between thyroid antigen...Basedowian orbitopathy is an autoimmune disease representing the most frequent extra-thyroidal manifestation. Its pathophysiology is imperfectly elucidated and is the result of cross-reactivity between thyroid antigens and orbital tissue. It is most frequently seen in the context of hyperthyroidism (basedow’s disease or Graves’ disease), sometimes hypothyroidism (Hashimoto’s thyroiditis), or euthyroidism. Diagnosis is often straightforward, but management remains difficult. The introduction of simple medical treatment exposes the patient to the risk of recurrence. In Sikasso, there have been few studies of Graves’ disease. The aim of this study was to describe the clinical, therapeutic and evolutionary features of Graves’ disease in Sikasso Hospital. The patient was a 35-year-old woman with no previous history of Graves’ disease and no history of alcohol or tobacco intoxication, consulting for bilateral exophthalmos with moderate pain for 1 year. Endocrine tests were normal (euthyroidism), as was orbital-cerebral MRI, which revealed stage II exophthalmos with no sellar or supra-saltar abnormalities. The main complication was exposure to keratitis. Our patient was treated with corticosteroids. The evolution was favorable under treatment, with no recurrence after one year’s follow-up. Graves’ disease is the most common cause of hyperthyroidism, but this should not obscure the diagnosis of euthyroidism, as demonstrated in this case report. Exophthalmos remains the main ophthalmological clinical manifestation.展开更多
鼻面及鼻眶脑真菌病(rhinofacial and rhino-orbital-cerebral mycosis,ROCM)是一种病死率高的暴发性真菌感染疾病,主要由毛霉目、虫霉目、蛙粪霉目真菌引起。曲霉属真菌多引起真菌性鼻窦炎,如果侵入邻近的鼻、面、眼眶组织,真菌可能会...鼻面及鼻眶脑真菌病(rhinofacial and rhino-orbital-cerebral mycosis,ROCM)是一种病死率高的暴发性真菌感染疾病,主要由毛霉目、虫霉目、蛙粪霉目真菌引起。曲霉属真菌多引起真菌性鼻窦炎,如果侵入邻近的鼻、面、眼眶组织,真菌可能会延伸到颅底和/或神经系统,从而危及生命。由于该类感染早期临床表现缺乏特异性,误诊率可能较高;此外,对曲霉的有效抗真菌治疗与其他真菌的抗真菌治疗有很大的不同。本文对PubMed和中文文献数据库的相关文献进行了系统的Meta分析,全面总结了引起ROCM的相关曲霉菌种类、分布、危险因素、临床表现、诊断和治疗。展开更多
Coronavirus disease 2019 is a highly contagious respiratory disease caused by severe acute respiratory syndrome coronavirus 2.This disease as well as its various treatments like steroids,antivirals,and antibacterials ...Coronavirus disease 2019 is a highly contagious respiratory disease caused by severe acute respiratory syndrome coronavirus 2.This disease as well as its various treatments like steroids,antivirals,and antibacterials can alter the immune state of the affected individuals and result in secondary infections such as mucormycosis.Mucormycosis is a well-known opportunistic fungal infection that affects immunocompromised subjects,particularly those with diabetes mellitus,prolonged antibiotic or steroid use,and patients with organ transplantation,neutropenia,and hematological malignancies.Rhino-orbital-cerebral mucormycosis is an aggressive disease owing to its ability to invade the blood vessels by fungal hyphae,leading to necrosis of the involved structures.Large cases were reported from India,indicating that this clinical entity shows a geographical variation.The affected patients are suffering on a clinical spectrum depending on the stage of the disease.Radiological assessment,including computerized tomography and magnetic resonance imaging,is necessary to evaluate the stage of the disease and choose the appropriate surgical treatment.A multidisciplinary approach is required to treat rhino-orbital-cerebral mucormycosis and includes local or intravenous antifungal drugs,debridement of the dead tissues,and appropriate management of any predisposing conditions.The disease has a very poor prognosis with a death rate of 50%.This review aimed to sum-marize the demographic and clinical risk factors,investigations,treatments,and outcomes of coronavirus disease 2019 patients with rhino-orbital-cerebral mucormycosis.展开更多
文摘Basedowian orbitopathy is an autoimmune disease representing the most frequent extra-thyroidal manifestation. Its pathophysiology is imperfectly elucidated and is the result of cross-reactivity between thyroid antigens and orbital tissue. It is most frequently seen in the context of hyperthyroidism (basedow’s disease or Graves’ disease), sometimes hypothyroidism (Hashimoto’s thyroiditis), or euthyroidism. Diagnosis is often straightforward, but management remains difficult. The introduction of simple medical treatment exposes the patient to the risk of recurrence. In Sikasso, there have been few studies of Graves’ disease. The aim of this study was to describe the clinical, therapeutic and evolutionary features of Graves’ disease in Sikasso Hospital. The patient was a 35-year-old woman with no previous history of Graves’ disease and no history of alcohol or tobacco intoxication, consulting for bilateral exophthalmos with moderate pain for 1 year. Endocrine tests were normal (euthyroidism), as was orbital-cerebral MRI, which revealed stage II exophthalmos with no sellar or supra-saltar abnormalities. The main complication was exposure to keratitis. Our patient was treated with corticosteroids. The evolution was favorable under treatment, with no recurrence after one year’s follow-up. Graves’ disease is the most common cause of hyperthyroidism, but this should not obscure the diagnosis of euthyroidism, as demonstrated in this case report. Exophthalmos remains the main ophthalmological clinical manifestation.
文摘Basedowian orbitopathy is an autoimmune disease representing the most frequent extra-thyroidal manifestation. Its pathophysiology is imperfectly elucidated and is the result of cross-reactivity between thyroid antigens and orbital tissue. It is most frequently seen in the context of hyperthyroidism (basedow’s disease or Graves’ disease), sometimes hypothyroidism (Hashimoto’s thyroiditis), or euthyroidism. Diagnosis is often straightforward, but management remains difficult. The introduction of simple medical treatment exposes the patient to the risk of recurrence. In Sikasso, there have been few studies of Graves’ disease. The aim of this study was to describe the clinical, therapeutic and evolutionary features of Graves’ disease in Sikasso Hospital. The patient was a 35-year-old woman with no previous history of Graves’ disease and no history of alcohol or tobacco intoxication, consulting for bilateral exophthalmos with moderate pain for 1 year. Endocrine tests were normal (euthyroidism), as was orbital-cerebral MRI, which revealed stage II exophthalmos with no sellar or supra-saltar abnormalities. The main complication was exposure to keratitis. Our patient was treated with corticosteroids. The evolution was favorable under treatment, with no recurrence after one year’s follow-up. Graves’ disease is the most common cause of hyperthyroidism, but this should not obscure the diagnosis of euthyroidism, as demonstrated in this case report. Exophthalmos remains the main ophthalmological clinical manifestation.
文摘鼻面及鼻眶脑真菌病(rhinofacial and rhino-orbital-cerebral mycosis,ROCM)是一种病死率高的暴发性真菌感染疾病,主要由毛霉目、虫霉目、蛙粪霉目真菌引起。曲霉属真菌多引起真菌性鼻窦炎,如果侵入邻近的鼻、面、眼眶组织,真菌可能会延伸到颅底和/或神经系统,从而危及生命。由于该类感染早期临床表现缺乏特异性,误诊率可能较高;此外,对曲霉的有效抗真菌治疗与其他真菌的抗真菌治疗有很大的不同。本文对PubMed和中文文献数据库的相关文献进行了系统的Meta分析,全面总结了引起ROCM的相关曲霉菌种类、分布、危险因素、临床表现、诊断和治疗。
文摘Coronavirus disease 2019 is a highly contagious respiratory disease caused by severe acute respiratory syndrome coronavirus 2.This disease as well as its various treatments like steroids,antivirals,and antibacterials can alter the immune state of the affected individuals and result in secondary infections such as mucormycosis.Mucormycosis is a well-known opportunistic fungal infection that affects immunocompromised subjects,particularly those with diabetes mellitus,prolonged antibiotic or steroid use,and patients with organ transplantation,neutropenia,and hematological malignancies.Rhino-orbital-cerebral mucormycosis is an aggressive disease owing to its ability to invade the blood vessels by fungal hyphae,leading to necrosis of the involved structures.Large cases were reported from India,indicating that this clinical entity shows a geographical variation.The affected patients are suffering on a clinical spectrum depending on the stage of the disease.Radiological assessment,including computerized tomography and magnetic resonance imaging,is necessary to evaluate the stage of the disease and choose the appropriate surgical treatment.A multidisciplinary approach is required to treat rhino-orbital-cerebral mucormycosis and includes local or intravenous antifungal drugs,debridement of the dead tissues,and appropriate management of any predisposing conditions.The disease has a very poor prognosis with a death rate of 50%.This review aimed to sum-marize the demographic and clinical risk factors,investigations,treatments,and outcomes of coronavirus disease 2019 patients with rhino-orbital-cerebral mucormycosis.
