title: Thiazolidinedione induced thyroid associated orbitopathy.
abstract: BACKGROUND
  To describe an episode of thyroid associated orbitopathy (TAO) following the initiation of thiazolidinedione (TZD).
  
  
  METHODS
  We report a female patient with a history of Graves' disease and stabilised thyroid associated orbitopathy for 2.5 years, who experienced rapid progression of TAO after the initiation of thiazolidinedione for glycemic control. Following the discontinuation of TZD, the patient experienced subsequent stabilisation of disease and normalization of vision. The medical history, ophthalmic findings, and clinical course are discussed.
  
  
  CONCLUSIONS
  Thiazolidinediones may exacerbate TAO, and this should be taken into consideration when selecting treatment for diabetic patients with a history of autoimmune thyroid disorders.
authors.affiliation: Division of Orbital and Ophthalmic Plastic and Reconstructive Surgery, Jules Stein Eye Institute, and the Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA. seongmu.lee@ucla.edu
authors.forename: Seongmu
authors.initials: S
authors.lastname: Lee
authors.forename: Angelo
authors.initials: A
authors.lastname: Tsirbas
authors.forename: Robert A
authors.initials: RA
authors.lastname: Goldberg
authors.forename: John D
authors.initials: JD
authors.lastname: McCann
mesh_terms: D004172:Diplopia / Q000139:chemically induced; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005094:Exophthalmos / Q000139:chemically induced; D005260:Female; D049970:Graves Ophthalmopathy / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008687:Metformin / Q000009:adverse effects; D008875:Middle Aged; D011433:Propranolol / Q000627:therapeutic use; D011441:Propylthiouracil / Q000627:therapeutic use; D019233:Retreatment; D000077154:Rosiglitazone; D045162:Thiazolidinediones / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D000077154:Rosiglitazone; D011441:Propylthiouracil; D008687:Metformin; D011433:Propranolol; C089946:2,4-thiazolidinedione