Two patients, previously diagnosed and treated for euthyroid, autoantibody-negative thyroid eye disease, presented with active orbitopathy. An atypical disease course and presentation prompted orbital biopsy. Extraocular muscle histopathology demonstrated noncaseating granulomatous inflammation consistent with presumed orbital sarcoidosis involving multiple extraocular muscles, including the in...

Idiopathic orbital pseudotumor is a benign, noninfectious, and nonneoplastic disease with unknown cause. It is the third most common orbital disease after thyroid orbitopathy and lymphoproliferative disorder. Idiopathic orbital pseudotumor is extremely rare in pediatric age group and may cause real diagnostic problems. This paper describes a 4-year-old girl who presented with sudden ptosis in t...

Thyroid orbitopathy is the most prevalent non-thyroid symptom in Graves' syndrome. It has a high incidence and particularly affects young women. Smoking is clearly involved in its development and progress, and in its response to different treatments. This autoimmune condition usually has a benign course, independent from hyperthyroidism, but its severe, progressive forms represent a major thera...

The clinical features of Graves’ orbitopathy (GO) with eyelid retraction (Dalrymple’s sign), lid-lag (von Graefe’s sign), lagophthalmos, exophthalmos, motility disorders and dysthyroid optic neuropathy (DON) are all well known. The underlying disease is autoimmune thyroid disease and it is often associated with pretibial myxedema and acropachy. The combination of bilateral exophthalmos, lid ret...

Purpose To describe the effect of tocilizumab in two patients with thyroid associated orbitopathy (TAO). Observations We present two patients with TAO who could not tolerate corticosteroids and had a reduction in clinical and laboratory markers of inflammatory activity with subsequent tocilizumab therapy. Conclusions and importance The IL-6 receptor antibody tocilizumab is a promising candi...