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Information × Registration Number 0223U002838, 0120U100642 , R & D reports Title Optimization of treatment of patients with diffuse toxic goiter with autoimmune ophthalmopathy based on the analysis of clinical and immunological features of the disease course and long-term results of treatment popup.stage_title Head Terechova Galyna M., Кандидат медичних наук Registration Date 10-03-2023 Organization State Institute "V.P. Komissarenko Institute Of Endocrinology And Metabolism of The National Academy of Medical Science of Ukraine" popup.description2 The object of the study: long-term results of treatment of patients with diffuse toxic goiter (DTG) with autoimmune ophthalmopathy (AO).The aim of the study: to optimize the treatment of DTG with AO. Research methods and equipment: ultrasound orbits, hormonal, immunoenzymatic, biochemical. Results: Patients with a stroke with AO during treatment with thyrostatic drugs were examined. Determination of the functional state of the thyroid gland (TSH) showed that euthyroidism occurred in 65% of patients, hyperthyroidism in 18%, and subclinical hyperthyroidism in 17%, the indicator of stimulating antibodies to the TSH receptor probably exceeded normal values. The level of pro-inflammatory cytokines - Il-1β increased in patients with DTS compared to the control group. In patients with an active stage of AO, the concentration level of IL-1β exceeded this indicator in the group of patients without AO, which may indicate the specificity of this cytokine as a marker of the activity of the inflammatory autoimmune process in the orbits. Clinical examination of the condition of the orbits revealed that the majority of individuals had stage III-IV AO according to NOSPECS and were active according to CAS - 5.2 points. After surgical treatment of DTG, the level of AbrTSH and tumor necrosis factor α probably decreases already after 6 months, and stay on minimum level after 24 months. In 14.3% of patients, the clinical featutes of ophthalmopathy significantly decreased, it was the disappearance of spontaneous retrobulbar pain, periorbital edema, conjunctival hyperemia, and chemosis. Patients with an active progressive course of autoimmune ophthalmopathy against the background of DTG were treated with cytostatics mofetil mycophenylate. A clear positive effect was obtained regarding the reduction of manifestations of AO activity according to the CAS scale, the treatment led to a decrease in the level of Ab rTSH and the level of C-reactive protein.  Product Description popup.authors Buldygina Yuliya V. Klochkova Viktoria M. Strafun Lesya S. popup.nrat_date 2023-03-10 Close