Abstract:
:Here we describe the case of a 41-year-old woman with a history of Cushing disease who had previously undergone unsuccessful neurosurgery, followed by stereotactic radiosurgery. More than 4 years after this treatment, she presented severe visual impairment, which started in the left eye and was documented by neuro-ophthalmic evaluation. Radiological assessment by contrast-enhanced magnetic resonance (MR) imaging initially suggested the diagnosis of glioma of the optic nerve and the patient started corticosteroid treatment (first with prednisone, 80 mg/day, followed by dexamethasone, 8 mg/day). Despite the therapy, vision in the left eye rapidly worsened until light was no longer perceptible; similar symptoms and signs also developed in the right eye, evolving to complete temporal hemianopsia. The clinical evidence was confirmed by the rapid progression of the MR picture, which showed homogeneous enhancement of the chiasm and optic nerves. On the basis of these findings, the original diagnosis of glioma was excluded, and radiation-induced optic neuropathy was diagnosed. As corticosteroids had proved inefficacious, hyperbaric oxygen (HBO) therapy was promptly instituted and vision steadily started to improve. This improvement was documented and confirmed by the progressive recovery of the visual field in the right eye and the changes in the sequential follow-up MR scanning. Optic neuropathy is an infrequent but dramatic complication of radiation therapy. Symptoms develop, on average, 12 months after treatment, and the onset may be acute and characterized by the progressive loss of vision in one or both eyes. HBO has already been used to treat this complication, but its efficacy is still controversial. Here, in addition to describing this particular case, which presented a significantly delayed radiation injury of the optic pathways, we provide a brief literature review and discuss some important points.
journal_name
Eur J Endocrinoljournal_title
European journal of endocrinologyauthors
Boschetti M,De Lucchi M,Giusti M,Spena C,Corallo G,Goglia U,Ceresola E,Resmini E,Vera L,Minuto F,Ferone Ddoi
10.1530/eje.1.02161subject
Has Abstractpub_date
2006-06-01 00:00:00pages
813-8issue
6eissn
0804-4643issn
1479-683Xpii
154/6/813journal_volume
154pub_type
杂志文章abstract:OBJECTIVES:Evidence of the association between vitamin D and cardiovascular risk factors in the young is limited. We therefore assessed the relationships between circulating 25-hydroxyvitamin D(3) (25(OH)D(3)) and metabolic syndrome (MetS), its components, and early atherosclerotic changes in 452 (304 overweight/obese ...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-11-0545
更新日期:2011-10-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-10-0397
更新日期:2010-07-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
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更新日期:2016-11-01 00:00:00
abstract:OBJECTIVE:To investigate the association between birth weight and risk of type 2 diabetes, abdominal obesity and hypertension among Chinese adults. RESEARCH METHODS AND PROCEDURES:Nine hundred and seventy-three individuals from a population-based cross-sectional survey for the prevalence of type 2 diabetes conducted i...
journal_title:European journal of endocrinology
pub_type: 杂志文章
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更新日期:2006-10-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章,多中心研究
doi:10.1530/EJE-16-0967
更新日期:2017-05-01 00:00:00
abstract::The ob protein, termed leptin, is produced by adipocytes and is thought to act as an afferent satiety signal regulating weight through suppressing appetite and stimulating energy expenditure in humans and/or rodents. Insulin has been found to be a potent stimulator of leptin expression in rodents. It is unclear at pre...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1380501
更新日期:1998-05-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-09-0769
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abstract::Osteoporosis is being increasingly recognised in paediatric practice as a consequence of several factors. These include the increasing complexity of chronic conditions and the associated treatments managed by paediatricians. In addition, the improved care provided to children with chronic illness has led to many of th...
journal_title:European journal of endocrinology
pub_type: 杂志文章,评审
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更新日期:2008-12-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-11-0059
更新日期:2011-05-01 00:00:00
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journal_title:European journal of endocrinology
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更新日期:2020-02-01 00:00:00
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journal_title:European journal of endocrinology
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更新日期:2004-12-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 临床试验,杂志文章
doi:10.1530/eje.0.1480669
更新日期:2003-06-01 00:00:00
abstract::A comparative study of high-dose (HD, carbimazole 60 mg plus thyroxine 100-150 micrograms daily) and titration-dose (TD) regimens of carbimazole was carried out in 70 patients with Graves' disease, the patients being assigned randomly to one or other regimen. The treatment was given for 1 year and follow-up was for 2 ...
journal_title:European journal of endocrinology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1994-08-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-07-0017
更新日期:2007-06-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-12-0565
更新日期:2012-12-01 00:00:00
abstract::Puberty is the period during which we attain adult secondary sexual characteristics and reproductive capability. Its onset depends upon reactivation of pulsative GNRH, secretion from its relative quiescence during childhood, on the background of intact potential for pituitary-gonadal function. This review is intended:...
journal_title:European journal of endocrinology
pub_type: 杂志文章,评审
doi:10.1530/EJE-13-0894
更新日期:2014-06-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.1.02145
更新日期:2006-05-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-18-0580
更新日期:2019-01-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-14-0930
更新日期:2015-05-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章,评审
doi:10.1530/EJE-08-0279
更新日期:2008-12-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1430213
更新日期:2000-08-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1310191
更新日期:1994-08-01 00:00:00
abstract::Administration of growth hormone (GH) to patients with growth hormone deficiency (GHD) has beneficial effects, but so far has been employed only empirically. We have, therefore, investigated the dose-dependent effect of GH on target tissue by studying biochemical markers of bone and collagen turnover in GHD. Then pati...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1350666
更新日期:1996-12-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.1.02064
更新日期:2006-01-01 00:00:00
abstract::X-linked adrenoleucodystrophy (ALD) has been shown to be one of the most frequent causes of Addison's disease in men. It is characterized by an impaired peroxisomal beta-oxidation of very long chain fatty acids and is associated with mutations of the ALD gene resulting in a defective peroxisomal membrane transport pro...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1370040
更新日期:1997-07-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-15-0567
更新日期:2015-12-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1500799
更新日期:2004-06-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章,评审
doi:10.1530/EJE-14-0077
更新日期:2014-04-10 00:00:00
abstract::All children and adolescents with Graves' disease in the county of Uppsala (catchment area population 250,000) treated between 1970 and 1994 were evaluated in a retrospective study. The material comprised 31 patients with a mean age of 11 years (range 4-16), 29 (94%) of whom were girls, and four (13%) of the patients ...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1340710
更新日期:1996-06-01 00:00:00
abstract::Maintenance of fluid homeostasis during periods of heightened physical stress can be best evaluated in humans using exercise as a model. Although it is well established that arginine vasopressin (AVP), aldosterone and atrial natriuretic peptide (ANP) are the principle hormones regulating fluid balance at rest, the pot...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-08-0064
更新日期:2008-12-01 00:00:00