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Biomedical subjects

R C Sergott

Publications and source records attributed to R C Sergott.

134 records · Page 8Linked to original sources
PubMed1979

E-rosette formation in Graves' ophthalmopathy.

We investigated the lymphocyte characteristics of 77 Graves' disease patients with and without infiltrative ophthalmopathy. Thirteen patients with infiltrative ophthalmopathy without prior antithyroid therapy and 20 euthyroid patients with progressive ophthalmopathy demonstrated decreased percentages of active and total erythrocyte rosette-forming lymphocytes compared to thyrotoxic patients without eye disease and to a control population (p less than 0.001). There was no significant difference in rosette-forming cells between untreated thyrotoxic and treated euthyroid patients with ophthalmopathy. No lymphocytotoxic antibodies or rosette inhibitory factor was present in the sera of patients with infiltrative ophthalmopathy. Untreated and treated patients with lid retraction and mild proptosis without extraocular muscle disease had decreased active rosette-forming cells (p less than 0.001) but normal total rosette-forming cells. Five patients with infiltrative ophthalmopathy who failed to improve with systemic corticosteroids demonstrated elevated active but normal total rosette-forming cells. Differences in rosette formation between ophthalmic and nonophthalmic Graves' disease may represent an associated cell-mediated abnormality that may explain why control of the thyrotoxic state need not correlate with the ophthalmic manifestations of the disorder.

Adult↗
PubMedDate not supplied

Graves' ophthalmopathy. A clinical and immunologic review.

Graves' thyroid disease and the orbitopathy which often accompanies it have puzzled physicians and scientists for more than 150 years. Although certain histopathological features have been documented, it is not known what mechanisms are responsible for the systemic and/or ocular disorders. The ocular condition characteristic of Graves' disease may exist in the absence of clinical or biochemical evidence of thyroid dysfunction, and when the systemic and ocular condition exist together, they may follow completely different clinical courses. Because the relationship between the thyroid disorder and the orbitopathy is not established, the authors refer not to "thyroid ophthalmopathy," but to "Graves' ophthalmopathy." In this review, histopathological features of Graves' ophthalmopathy are reviewed. The differential diagnosis of the ophthalmopathy and approaches to its evaluation are discussed, notably the T-4 radioimmunoassay, T-3 resin uptake and TSH tests, as well as CT scanning and ultrasonography. The characteristics of Classes 0-6 ophthalmopathy are outlined and the management of cases in each class is considered. The possible immunological basis for Graves' ophthalmopathy is also reviewed.

Eye Diseases↗
PubMedDate not supplied

Current concepts of the pathogenesis of optic neuritis associated with multiple sclerosis.

Optic neuritis may occur as an isolated entity or as a manifestation of multiple sclerosis (MS), a widespread central nervous system demyelinating disease. Clinical, electrophysiological, magnetic resonance imaging and neuropathologic data support the hypothesis that "idiopathic" optic neuritis represents a restricted form of MS. The current evidence for viral, cell mediated, and antibody-induced etiologies of MS and optic neuritis are reviewed.

Autoantibodies↗
PubMedDate not supplied

Not so slowly progressive visual loss.

A 51-year-old man presented with bilateral progressive visual loss during a 2-month period. Visual acuity was 20/60 in both eyes with bilateral constricted visual fields. Funduscopy revealed bilateral disk pallor and arteriolar attenuation. His vision declined rapidly during the next 2 weeks. Investigations showed a positive cerebrospinal fluid Venereal Disease Research Laboratory test (1:8). A diagnosis of neurosyphilis was made, and treatment was started with high-dose intravenous and intramuscular penicillin.

Antibodies, Bacterial↗
PubMedDate not supplied

MR imaging of Tolosa-Hunt syndrome.

The Tolosa-Hunt syndrome consists of painful ophthalmoplegia caused by cavernous sinus inflammation, which is responsive to steroid therapy. The MR features of 11 patients with the clinical diagnosis of Tolosa-Hunt syndrome were studied. Two patients had normal MR studies of the orbit and cavernous sinuses. In nine patients, abnormal signal and/or mass lesions were seen in the cavernous sinuses; in eight cases, the abnormality was hypointense relative to fat and isointense with muscle on short TR/TE images and isointense with fat on long TR/TE scans. Extension into the orbital apex was seen in eight cases. In six of nine cases the affected cavernous sinus was enlarged; in five of nine it had a convex outer margin. One patient had a thrombosed cavernous sinus and superior ophthalmic vein in addition to a cavernous sinus soft-tissue mass. The signal intensity of Tolosa-Hunt syndrome in this limited series was similar to that of orbital pseudotumor and is confined to a limited differential diagnosis, which includes meningioma, lymphoma, and sarcoidosis.

Adolescent↗
PubMedDate not supplied

Internuclear ophthalmoplegia: MR-anatomic correlation.

Internuclear ophthalmoplegia is a gaze disorder characterized by impaired adduction on the side of a lesion involving the medial longitudinal fasciculus with dissociated nystagmus of the abducting eye. Eleven patients with internuclear ophthalmoplegia (nine with clinical multiple sclerosis, two with clinical infarction) underwent MR imaging with spin-echo techniques on a 1.5-T system. Nine patients also had CT. MR showed focal or nodular areas of high signal intensity on T2-weighted images in the region of the medial longitudinal fasciculus in 10 of 11 patients. In one of four patients with internuclear ophthalmoplegia who had MR after intravenous gadolinium-DTPA, an enhancing ring lesion was seen in the region of the medial longitudinal fasciculus on short TR/TE images, indicating active blood-brain-barrier disruption, which correlated with this patient's recent-onset internuclear ophthalmoplegia. CT failed to show the lesions in all nine patients examined. This report demonstrates the superiority of MR in evaluating gaze disorders attributable to brainstem dysfunction, such as internuclear ophthalmoplegia, and correlates MR findings with the relevant neuroanatomy of the medial longitudinal fasciculus.

Adolescent↗
PubMedDate not supplied

Dural malformations with ophthalmic manifestations: results of particulate embolization in seven patients.

Seven patients with proptosis, chemosis, diplopia, and elevated intraocular pressure were found to have dural arteriovenous malformations with drainage into the cavernous sinus and superior ophthalmic vein. These patients had sufficient symptoms to justify therapeutic embolization with polyvinyl alcohol. Five of seven patients had complete resolution of their ophthalmic symptoms after embolization; the other two had transient improvement. Follow-up was 9-29 months. When 50% or more of the vessels supplying a malformation were embolized, complete relief of symptoms was obtained. Particulate embolization is an effective therapeutic approach in patients with significant ophthalmologic symptoms from dural malformations.

Adult↗