Эндокринная офтальмопатия: исторические аспекты

Abstract

The article presents the history of the development of the treatment of endocrine ophthalmopathy from the first mention of disparate symptoms of the disease in 110 ad to the principles of therapy accepted today. Caleb parry was the first to describe 8 such patients, but his work did not attract the attention of the medical community. In 1835, the Englishman robert graves, in his «clinical lectures», described 3 patients with a disease that was later named after him. a little later, the clinical cases of 4 patients were presented by Karl Basedow, who also suggested that the body was «poisoned» with a toxin as a result of the disease. treatment of toxic goiter with exophthalmos remained symptomatic for a long time. Surgery was resorted to as a «treatment of despair» in neglected patients, which led to high mortality after operations. attempts at surgical intervention on the eye sockets were also ineffective. But at the beginning of the 20th century, several discoveries were made that significantly influenced the effectiveness of treatment. Since 1902, x-ray and then radioisotope irradiation of the thyroid gland entered clinical practice, which led to the recovery of 2/3 of patients. developing after radiotherapy and surgery, hypothyroidism began to stop thyroxine, synthesized in 1926 by charles harrington. the discovery of the thyrostatic properties of thiourea by Edwin astwood in 1946 made it possible to significantly improve the effectiveness of the treatment of patients with hyperthyroidism. the modern era in the treatment of endocrine ophthalmopathy began in the 90s of the last century, when pulse therapy with high doses of glucocorticoid hormones was first proposed. therapy with high-dose corticosteroids remains the «gold standard» for the treatment of endocrine ophthalmopathy to this day. Keywords: endocrine ophthalmopathy, exophthalmos, goiter, thyroid gland, study history