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Case Report
 
Rituximab therapy in steroid resistant thyroid associated ophthalmopathy
 
Praveen Devarbhavi1, Animesh Maiti2, Anirban Sinha3, Asish Kumar Basu4, Satyam Chakraborty5, Lakshmi Dey5, Subir Swar5, Kingshuk Bhattacharjee6
 
1DM Post-Doctoral Trainee, Department of Endocrinology and Metabolism, Medical College and Hospital, 88, College Street; Kolkata
2Associate Professor, Department of Endocrinology and Metabolism, Medical College and Hospital, 88, College Street; Kolkata
3Assistant professor, Department of Endocrinology and Metabolism, Medical College and Hospital, 88, College Street; Kolkata
4Head of Department, Department of Endocrinology and Metabolism, Medical College and Hospital, 88, College Street; Kolkata
5DM Post-Doctoral Trainee, Department of Endocrinology and Metabolism, Medical College and Hospital, 88, College Street; Kolkata
6Assistant Manager, Medical Services, Biocon LTD, Bangalore

Article ID: 100036CRINTPD2017
doi:10.5348/crint-2017-36-CR-5

Address correspondence to:
Dr. Praveen Devarbhavi
DM Post-Doctoral Trainee, Department of Endocrinology and Metabolism
Medical College and Hospital, 88, College Street
Kolkata

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How to cite this article
Devarbhavi P, Maiti A, Singha A, Basu AK, Chakraborty S, Dey L, Swar S, Bhattacharjee K. Rituximab therapy in steroid resistant thyroid associated ophthalmopathy. Case Rep Int 2017;6:17–20.


ABSTRACT
Introduction: Thyroid associated ophthalmopathy (TAO) is the most frequent extrathyroidal manifestation of Graves’ disease. Considerable number of TAO is also found with euthyroid or hypothyroid state and responds to present mainstay of therapy i.e corticosteroid. However, some patients with TAO are resistant to steroid therapy and may progress to vision threatening orbitopathy. Radiotherapy, surgical decompression and cyclosporine in combination with oral or intravenous glucocorticoid were the other options in such cases. But recently rituximab a monoclonal anti CD20 antibody which was successfully used in other autoimmune diseases like rheumatoid arthritis is now introduced as a novel therapeutic option in TAO particularly in steroid resistant cases. Herein, we report a case of euthyroid TAO resistant to glucocorticoid therapy that responded to rituximab.

Keywords: Rituximab, Steroid resistant orbitopathy, Thyroid associated ophthalmopathy


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Author Contributions
Praveen Devarbhavi – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Animesh Maiti – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Anirban Sinha – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Asish Kumar Basu – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Satyam Chakraborty – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Lakshmi Dey – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Subir Swar – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Kingshuk Bhattacharjee – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 Praveen Devarbhavi et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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