Biomaterial Database

Intravenous cyclophosphamide pulse therapy is effective for refractory Graves' ophthalmopathy. 2006

Takahisa Tanikawa, and Yosuke Okada, and Yoshiya Tanaka

The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan. Yahatanishi-ku, Kitakyushu 807-8555, Japan.

Graves' ophthalmopathy is the most frequent extrathyroidal manifestation of Graves' disease. Although glucocorticoids and orbital radiotherapy have been used and are effective for the disease, we often experience cases refractory to either therapy. We report here a case that did not respond satisfactorily to either therapy and was later successfully treated by intravenous cyclophosphamide (IV-CY) pulse therapy. A 31 year old woman presented with typical Graves' disease and ophthalmopathy. After establishing a euthyroid state, she received intravenous glucocorticoid pulse therapy and orbital radiotherapy. Although this induced the resolution of the ophthalmopathy, it was temporary and thyroid-stimulating antibody (TSAb) increased to high titers, associated with relapse of ophthalmopathy 2 months after the treatment. Four courses of IV-CY pulse therapy were administered, which resulted in complete improvement of the symptoms and normalization of the TSAb titers. We suggest that IV-CY pulse therapy might be useful for Graves' ophthalmopathy, especially for patients refractory to glucocorticoid pulse therapy.

UI	MeSH Term	Description	Entries
D007275	Injections, Intravenous	Injections made into a vein for therapeutic or experimental purposes.	Intravenous Injections,Injection, Intravenous,Intravenous Injection
D003520	Cyclophosphamide	Precursor of an alkylating nitrogen mustard antineoplastic and immunosuppressive agent that must be activated in the LIVER to form the active aldophosphamide. It has been used in the treatment of LYMPHOMA and LEUKEMIA. Its side effect, ALOPECIA, has been used for defleecing sheep. Cyclophosphamide may also cause sterility, birth defects, mutations, and cancer.	(+,-)-2-(bis(2-Chloroethyl)amino)tetrahydro-2H-1,3,2-oxazaphosphorine 2-Oxide Monohydrate,B-518,Cyclophosphamide Anhydrous,Cyclophosphamide Monohydrate,Cyclophosphamide, (R)-Isomer,Cyclophosphamide, (S)-Isomer,Cyclophosphane,Cytophosphan,Cytophosphane,Cytoxan,Endoxan,NSC-26271,Neosar,Procytox,Sendoxan,B 518,B518,NSC 26271,NSC26271
D004334	Drug Administration Schedule	Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience.	Administration Schedule, Drug,Administration Schedules, Drug,Drug Administration Schedules,Schedule, Drug Administration,Schedules, Drug Administration
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328	Adult	A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available.	Adults
D049970	Graves Ophthalmopathy	An autoimmune disorder of the EYE, occurring in patients with Graves disease. Subtypes include congestive (inflammation of the orbital connective tissue), myopathic (swelling and dysfunction of the extraocular muscles), and mixed congestive-myopathic ophthalmopathy.	Graves Eye Disease,Ophthalmopathy, Infiltrative,Ophthalmopathy, Thyroid-Associated,Thyroid Eye Disease,Thyroid-Associated Ophthalmopathy,Congestive Ophthalmopathy,Dysthyroid Ophthalmopathy,Edematous Ophthalmopathy,Graves Orbitopathy,Myopathic Ophthalmopathy,Ophthalmopathies, Thyroid-Associated,Thyroid-Associated Ophthalmopathies,Congestive Ophthalmopathies,Disease, Graves Eye,Disease, Thyroid Eye,Dysthyroid Ophthalmopathies,Edematous Ophthalmopathies,Eye Disease, Graves,Eye Disease, Thyroid,Infiltrative Ophthalmopathies,Infiltrative Ophthalmopathy,Myopathic Ophthalmopathies,Ophthalmopathy, Congestive,Ophthalmopathy, Dysthyroid,Ophthalmopathy, Edematous,Ophthalmopathy, Graves,Ophthalmopathy, Myopathic,Ophthalmopathy, Thyroid Associated,Orbitopathy, Graves,Thyroid Associated Ophthalmopathies,Thyroid Associated Ophthalmopathy,Thyroid Eye Diseases
D020551	Pulse Therapy, Drug	Administration of high doses of pharmaceuticals over short periods of time.	Drug Pulse Therapy,Pulse Drug Therapy,Drug Pulse Therapies,Drug Therapies, Pulse,Drug Therapy, Pulse,Pulse Drug Therapies,Pulse Therapies, Drug,Therapies, Drug Pulse,Therapies, Pulse Drug,Therapy, Drug Pulse,Therapy, Pulse Drug