The cause of Exophthalmos in Grave's Disease - USMLE Forums
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Old 01-16-2012
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Thyroid The cause of Exophthalmos in Grave's Disease

* Goljan says that exophthalmos is caused by the deposition of Glycosaminoglycans (GAG) in the orbital fat,

* Sattar's Pathoma said that it was a fibroblast proliferation.

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Old 01-16-2012
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Both are correct!

The pathogenesis of Graves' ophthalmopathy is becoming more clearly understood. The volume of both the extraocular muscles and retroorbital connective and adipose tissue is increased, due to inflammation and the accumulation of hydrophilic glycosaminoglycans (GAG), principally hyaluronic acid, in these tissues. GAG secretion by fibroblasts is increased by activated T-cell cytokines such as tumor necrosis factor (TNF) alpha and interferon gamma, implying that T-cell activation is an important part of this immunopathology. The accumulation of GAG causes a change in osmotic pressure, which in turn leads to a fluid accumulation and an increase in pressure within the orbit. These changes displace the eyeball forward and can also interfere with the function of the extraocular muscles and the venous drainage of the orbits.

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Abdulaziz (01-16-2012), aungawa (03-21-2012), Casandra (01-17-2012), DocSikorski (01-16-2012), hassansiraj (01-17-2012), Hitman (01-16-2012), mar_isa (05-09-2012), menatallah Elgohary (01-19-2012)


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