Resumen

Graves’ disease is the most frequent cause of hyperthyroidism, affecting mainly young aged women, with an etiology of autoimmune basis. One of its manifestations, Graves’ ophthalmopathy whose pathophysiology is unknown, represents one of the greatest therapeutic challenges in these patients, because they require aggressive treatment with steroids and multiple subsequent reconstructive surgeries in certain cases. It also represents a high burden to the health system. Drugs targeting B cells have been very effective for many autoimmune diseases. Rituximab is a murine humanized monoclonal antibody against CD20 + cells currently being studied in various autoimmune diseases including Graves’ disease. The objective of this paper is to expose possible mechanisms by which rituximab could act in both hyperthyroidism and ophthalmopathy of Graves’ disease, as well as the experience with its use acquired so far. The employment of rituximab in recently diagnosed patients or with mild ophthalmopathy is questionable with the evidence available today, however, we think that it may have a role in refractory cases or those who have a contraindication for steroid use.

Palabras clave: Graves’ disease Graves’ ophthalmopathy rituximab hyperthyroidism monoclonal antibodies.

2013-10-17   |   410 visitas   |   Evalua este artículo 0 valoraciones

Vol. 63 Núm.5. Septiembre-Octubre 2011 Pags. 536-543 Rev Invest Clin 2011; 63(5-ENGLISH)