title: Endocrine ophthalmopathy in a patient under continuous immunosuppressive therapy after cardiac transplantation.
abstract: We present the case of a female patient who has been on immunosuppressive therapy consisting of cyclosporin A and prednisolone for 9 years because of heterotopic (auxiliary) heart transplantation in 1984. In 1992 the patient developed Graves' disease followed by endocrine ophthalmopathy class IV 1 year later. To our knowledge this is the first report on Graves' disease with subsequent severe endocrine ophthalmopathy in a patient under immunosuppressive treatment with cyclosporin A and prednisolone in doses that effectively prevent heart transplant rejection. Prednisolone, which is used as a first line treatment of endocrine ophthalmopathy, and cyclosporin A, both inhibit T cell function. However, in this patient they were not effective in preventing the development of Graves' disease with subsequent endocrine ophthalmopathy, both of which are autoimmune diseases.
authors.affiliation: Department of Internal Medicine, University of Innsbruck, Austria.
authors.forename: G
authors.initials: G
authors.lastname: Höfle
authors.forename: R
authors.initials: R
authors.lastname: Moncayo
authors.forename: I
authors.initials: I
authors.lastname: Baldissera
authors.forename: R
authors.initials: R
authors.lastname: Pfister
authors.forename: G
authors.initials: G
authors.lastname: Finkenstedt
mesh_terms: D000328:Adult; D016572:Cyclosporine / Q000009:adverse effects*; D005128:Eye Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000532:radiotherapy; D005260:Female; D006111:Graves Disease / Q000139:chemically induced / Q000150:complications* / Q000532:radiotherapy; D016027:Heart Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007429:Intraocular Pressure / Q000187:drug effects / Q000502:physiology; D011239:Prednisolone / Q000009:adverse effects*; D014055:Tomography, Emission-Computed
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone