KMID : 0356620110260040335
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Journal of Korean Society of Endocrinology 2011 Volume.26 No. 4 p.335 ~ p.339
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Ophthalmopathy Induced by Bilateral Carotid Cavernous Fistula in a Patient with Graves¡¯ Disease
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Ha Jong-Kun
Suk Ji-Hye Jo A-Ra Jung Chan-Woo Kim Bong-jae Park Seong-Oh Kim Sang-Soo Kim Mi-Kyung
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Abstract
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Graves¡¯ disease (GD) can lead to specific eye afflictions including proptosis, periorbital swelling, conjunctival injection, chemosis, and opthalmoplegia, which then become a condition called Graves¡¯ ophthalmopathy or thyroid-associated ophthalmopathy (TAO). A carotid cavernous fistula (CCF) is an abnormal vascular communication between the carotid artery and the cavernous sinus. The clinical signs of CCF are very similar to TAO and should be considered as a differential diagnosis of TAO. We would like to present an interesting case of a bilateral ophthalmopathy induced by CCF in a GD patient. A 54-year-old man with a 6-year history of GD presented with bilateral exophthalmos and conjunctival injection for two months. The orbital CT scan findings were consistent with CCF, and an angiography revealed bilateral CCF. He received a bilateral coil embolization for the CCF and his ophthalmic signs were immediately improved. We recommend orbital imaging to exclude other coexisting diseases in patients who are suspected of TAO, especially when the diagnosis is uncertain or when determining whether medical or surgical intervention is appropriate.
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KEYWORD
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Carotid cavernous fistula, Graves¡¯ disease, Ophthalmopathy
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