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Existing treatments for severe Graves'ophthalmopathy such as immunosuppressive agents,orbital irradiation,and decompression are not fully satisfactory.The extraocular muscles and fat cells show immunoreactivity to insulin-like growth factor-1(IGF-1),and this factor is also implicated in the pathogenesis of pretibial myxoedema.Octreotide,a potent long acting somatostatin analogue,suppresses IGF-1 activity either indirectly,by reducing plasma concentrations of growth hormone or directly,by blocking the effect of IGF-1 on peripheral tissue.We report the therapeutic effect of octreotide in six patients with Graves' ophthalmopathy,three of whom also had pretibial myxoedema. |
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