Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0344232 (blurred vision)
 2,072 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Among incident cases of GO in Olmsted County, Minnesota: GO affected females six times more frequently than males (86% versus 14% of cases, respectively). The age-adjusted incidence rate was 16 cases per 100,000 population per year for females and 2.9 cases per 100,000 population for males. The peak incidence rates were bimodal, occurring in the age groups 40 to 44 years and 60 to 64 years in females and 45 to 49 years and 65 to 69 years in males. Among patients with GO, approximately 90% had Graves' hyperthyroidism, 1% had primary hypothyroidism, 3% had Hashimoto's thyroiditis, and 5% were euthyroid. Eyelid retraction was the most common ophthalmic feature of autoimmune thyroid disease, being present either unilaterally or bilaterally in more than 90% of patients at some point in their clinical course. Exophthalmos of one or both eyes affected approximately 60% of patients, restrictive extraocular myopathy was apparent in about 40% of patients, and optic nerve dysfunction occurred in either one or both eyes in 6% of patients with autoimmune thyroid disease. Only 5% of patients had the complete constellation of classic findings: eyelid retraction, exophthalmos, optic nerve dysfunction, extraocular muscle involvement, and hyperthyroidism. Upper eyelid retraction, either unilateral or bilateral, was documented in approximately 75% of patients at the time of diagnosis of GO. Lid lag also was a frequent early sign, being present either unilaterally or bilaterally in 50% of patients at the initial examination. At the time of diagnosis of GO, the most frequent ocular symptom was pain or discomfort, which affected 30% of patients. Some degree of diplopia was noted by approximately 17% of patients, lacrimation or photophobia was present in about 15% to 20% of patients, and 7.5% of patients complained of blurred vision. Decreased vision attributable to optic neuropathy was present in less than 2% of eyes at the time of diagnosis of GO. Thyroid dermopathy and acropachy accompanied GO in approximately 4% and 1% of patients, respectively. Myasthenia gravis occurred in less than 1% of patients. Superior limbic keratoconjunctivitis was documented in less than 4% of patients. The median age at the time of diagnosis of GO was 43 years (range, 8 to 88). Among patients with hyperthyroidism, 61% developed ophthalmopathy within 1 year of the onset of thyrotoxicosis. Symptoms and signs for which statistically significant changes occurred between the initial and final examinations included lacrimation, pain or ocular discomfort, photophobia, eyelid retraction, lid lag, eyelid fullness, conjunctival injection, chemosis, and exophthalmos.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:The epidemiologic characteristics and clinical course of ophthalmopathy associated with autoimmune thyroid disease in Olmsted County, Minnesota. 788 78

General agreement has emerged that the perceptions of patients of how they are feeling and how they are able to function in daily life should be included in the evaluation and monitoring of the effects of disease and treatment. Thyroid-associated orbitopathy (TAO), an inflammatory autoimmune eye disease, affects 50%-60% of patients with Graves' hyperthyroidism. Having blurred vision and/or diplopia has a detectable and significant impact on functional status and well-being, especially in role limitations caused by physical health problems. Therefore, to assess the impact of TAO on quality of life, we performed a descriptive study on consecutive ophthalmopathy patients with varying degrees of severity of TAO. General quality of life was assessed using a brief, internationally accepted, and standardized general questionnaire: the Medical Outcomes Study (MOS-36). In comparison to a large German reference group, low scores on the MOS-36 were found. Marked and significant differences from the control group were especially observed for the following items: vitality, social functioning, mental health, health perceptions, and body pain. MOS-36 did not correlate with the duration or severity of the ophthalmopathy. These results demonstrate the impact of a common visual symptom on health status and well-being, as measured by the MOS-36. In addition, comparison of the impact of various symptoms and conditions provides important and potentially clinically relevant information. In conclusion, we have shown that TAO has a large influence on the quality of life of these patients. The negative impact on well-being seems not to be related to the usual clinical assessment. These findings underscore the need for quality of-life measurements in prospective and controlled clinical trials.
Thyroid 2002 Mar
PMID:Psychosocial factors in subjects with thyroid-associated ophthalmopathy. 1195 46

Our objectives were to investigate thyroid abnormalities and autoimmunity in 120 patients affected by fibromyalgia (FM) and to study their relationships with clinical data and symptoms. Thyroid assessment by means of antithyroglobulin antibodies, antithyroid peroxidase antibodies, free triiodo-thyronine, free thyroxine, and thyroid stimulating hormone analyses was carried out. The clinical parameters "Fibromyalgia Impact Questionnaire", pain, tender points, fatigue, and other symptoms, and the presence of depression or anxiety disorders were evaluated. The basal thyroid hormone levels of FM patients were in the normal range, while 41% of the patients had at least one thyroid antibody. Patients with thyroid autoimmunity showed a higher percentage of dry eyes, burning, or pain with urination, allodynia, blurred vision, and sore throat. Correlations found between thyroid autoimmunity and age or with the presence of depression or anxiety disorders were not significant. However, in the cohort of post-menopausal patients, the frequency of thyroid autoimmunity was higher with respect to pre-menopausal patients. In conclusion, autoimmune thyroiditis is present in an elevated percentage of FM patients, and it has been associated with the presence of typical symptoms of the disease.
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PMID:Association between thyroid autoimmunity and fibromyalgic disease severity. 1748 49

Standard therapy for patients with hypothyroidism is replacement with synthetic thyroxine (T4). However, thyroxine plus triiodothyronine (T3) replacement therapy resulted in marked improvements in several items of the Profile of Mood States and in a few indices of psychometric function and quality of life. The adequacy of thyroxine alone versus thyroxine plus triiodothyronine to treat hypothyroidism has yielded conflicting results. Therefore, we conducted a systematic review of all included published, randomized controlled trials to evaluate the effects of thyroxine alone or thyroxine plus triiodothyronine replacement therapy for hypothyroidism. We electronically searched Medline, Embase, the Cochrane Library, and China National Infrastructure. We also manually searched the Chinese Journal of Isotopes, Radiologia pratica, and the Chinese Journal of Endocrinology and Metabolism. A total of 10 randomized, double-blind trials (six crossovers, four parallel trials) were identified. Pooled analyses were suggestive of a statistically significant increase of free and total triiodothyronine, significant decrease of serum-free and total thyroxine in patients treated with thyroxine plus triiodothyronine, weighted mean difference (WMD) 0.03, -31.25, 2.19, 3.00; 95% confidence interval (CI) -0.14 to 0.20, -47.04 to -15.47, 0.46-3.92, 1.64-4.36, respectively. Thyroxin alone indicated significant benefits for psychological or physical well-being in terms of the General Health Questionnaire-28 (WMD: -2.90; 95% CI: -3.18 to -2.63), general health (WMD: -0.38; 95% CI: -0.71 to -0.05), physical component summary (WMD: 0.7; 95% CI: 0.53-0.87), and mental component summary (WMD: 0.58; 95% CI: 0.25-0.75); physical functioning (WMD: 1.60; 95% CI: 1.29-1.90), role-physical test (WMD: 3.60; 95% CI: 2.66-4.54), bodily pain (WMD: 2.50; 95% CI: 2.11-2.88), role-emotional (WMD: 2.08; 95% CI: 1.17-2.99), mental health (WMD: 1.30; 95% CI: 0.97-1.64) in items of the Short Form-36 Health Survey; general well-being in items of the Thyroid Symptom Questionnaire (WMD: -1.90; 95% CI: -2.48 to -1.32); better performance in the Letter Number Sequencing-working memory test in items of cognitive performance scores (WMD: 1.10; 95% CI: 0.08-2.13), significant treatment effect for blurred vision, aches, and pain (WMD: -4.66, -0.80; 95% CI: -5.339 to -4.00, -1.34 to -0.26, respectively). However, T4 plus T3 replacement improved cognitive performance (WMD: -0.49; 95% CI: -0.90 to -0.08). No significant statistical differences were found in biochemical variables, mood states clinical variables, adverse effects, and drop-out. In subgroup analysis, two included studies examined the relationship between mental improvement and causes of hypothyroidism, autoimmune, and nonautoimmune hypothyroidism, respectively. T4 alone suggested significantly higher total T4 (autoimmune and nonautoimmune thyroid, WMD: 4.5, 3.7; 95% CI: 2.24-6.76, 1.66-5.74, respectively), and significantly decreased thyroid-stimulating hormone (WMD: -0.05; 95% CI: -0.09 to -0.01). Statistically significant improvement occurred in pairs correctly recalled in the Digit Symbol Test for T4 plus T3 replacement (WMD: -1.60; 95% CI: -2.97 to -0.23) for nonautoimmune thyroid. In conclusion, on the basis of data from recent studies, we conclude that combined T4 and T3 treatment does not improve well-being, cognitive function, or quality of life compared with T4 alone. T4 alone may be beneficial in improving psychological or physical well-being. According to the current evidence, T4 alone replacement may remain the drug of choice for hypothyroid patients.
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PMID:Thyroxine alone or thyroxine plus triiodothyronine replacement therapy for hypothyroidism. 1949 14

Celery (Apium graveolens) is a popular medicinal herb that used conventionally for the treatment of different diseases. This report aimed to demonstrate celery would induce hyperthyroidism after oral celery extract consumption for weight loss. A 36-year-old female patient came to our clinic with blurred vision, palpitation, and nausea. Dietary history showed that she used 8 g/day of celery extract in powder form for weight reduction. Weight loss during 78 days of celery extract consumption was 26 kg. Thyroid function test showed that serum level of thyroid-stimulating hormone (TSH) and T4 were 0.001 mIU/L and 23 ng/dl, respectively). Grave's and thyrotoxicosis ruled out by other laboratory evaluations. Methimazole 10 mg/day was prescribed. Serum level of TSH was evaluated. The celery extraction intake was discontinued when started treatment with methimazole. Not found any thyroid stimulator (thyroxin and other) in celery extraction. We concluded that observed hyperthyroidism and allergic reaction may be induced by celery extract consumption. Therefore, it is possible that hyperthyroidism may be a side effect of frequent celery extract consumption.
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PMID:Effect of Celery Extract on Thyroid Function; Is Herbal Therapy Safe in Obesity? 3114 29