{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T21:48:23Z","timestamp":1766180903081},"reference-count":10,"publisher":"FapUNIFESP (SciELO)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Einstein (S\u00e3o Paulo)"],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:p>ABSTRACT The diagnosis of Graves\u2019 orbitopathy is usually straightforward. However, orbital diseases that mimick some clinical signs of Graves\u2019 orbitopathy may cause diagnostic confusion, particularly when associated to some form of thyroid dysfunction. This report describes the rare occurrence of localized inferior rectus muscle amyloidosis in a patient with autoimmune hypothyroidism, who was misdiagnosed as Graves\u2019 orbitopathy. A 48-year-old man complained of painless progressive proptosis on the left side and intermittent vertical diplopia for 6 months. The diagnosis of Graves\u2019 orbitopathy was entertained after magnetic resonance imaging revealing a markedly enlarged, tendon-sparing inferior rectus enlargement on the left side, and an autoimmune hypothyroidism was disclosed on systemic medical workup. After no clinical improvement with treatment, the patient was referred to an ophthalmologist and further investigation was performed. The presence of calcification in the inferior rectus muscle on computed tomography, associated with the clinical findings led to a diagnostic biopsy, which revealed amyloid deposition. This report emphasizes that a careful evaluation of atypical forms of Graves\u2019 orbitopathy may be crucial and should include, yet with rare occurrence, amyloidosis in its differential diagnosis.<\/jats:p>","DOI":"10.1590\/s1679-45082016rc3744","type":"journal-article","created":{"date-parts":[[2017,1,7]],"date-time":"2017-01-07T21:32:41Z","timestamp":1483824761000},"page":"553-556","source":"Crossref","is-referenced-by-count":12,"title":["Isolated primary amyloidosis of the inferior rectus muscle mimicking Graves\u2019 orbitopathy"],"prefix":"10.1590","volume":"14","author":[{"given":"M\u00e1rio Luiz Ribeiro","family":"Monteiro","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Universidade de S\u00e3o Paulo,  Brazil","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allan Christian Pieroni","family":"Gon\u00e7alves","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alanna Mara Pinheiro Sobreira","family":"Bezerra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Hospital Israelita Albert Einstein,  Brazil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"issue":"2","key":"ref1","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1097\/WNO.0000000000000132","article-title":"The pathophysiology of thyroid eye disease","volume":"34","author":"Shan SJ","year":"2014","journal-title":"J Neuroophthalmol"},{"issue":"6","key":"ref2","doi-asserted-by":"publisher","first-page":"792","DOI":"10.1016\/S0002-9394(14)72787-4","article-title":"Diagnostic criteria for Graves\u2019 ophthalmopathy","volume":"119","author":"Bartley GB","year":"1995","journal-title":"Am J Ophthalmol"},{"issue":"5","key":"ref3","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1097\/MAJ.0b013e3182582330","article-title":"Orbital lymphoma mimicking ophthalmopathy in a patient with Graves\u2019","volume":"344","author":"Moura Neto A","year":"2012","journal-title":"Am J Med Sci"},{"issue":"3","key":"ref4","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1136\/bjo.87.3.370","article-title":"Unilateral proptosis: the role of medical history","volume":"87","author":"Kamminga N","year":"2003","journal-title":"Br J Ophthalmol"},{"issue":"11","key":"ref5","doi-asserted-by":"publisher","first-page":"1327","DOI":"10.6061\/clinics\/2012(11)18","article-title":"Imaging studies for diagnosing Graves\u2019 orbitopathy and dysthyroid optic neuropathy","volume":"67","author":"Gon\u00e7alves AC","year":"2012","journal-title":"Clinics"},{"issue":"3","key":"ref6","first-page":"435","article-title":"Inferior rectus muscle metastasis as a presenting sign of renal cell carcinoma: case report","volume":"69","author":"Gon\u00e7alves AC","year":"2006","journal-title":"Arq Bras Oftalmol"},{"issue":"4","key":"ref7","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1097\/01.IOP.0000132179.74910.79","article-title":"Enlarged extraocular muscles as the presenting feature of acromegaly","volume":"20","author":"Zafar A","year":"2004","journal-title":"Ophthal Plast Reconstr Surg"},{"issue":"5","key":"ref8","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1590\/S0004-27492011000500015","article-title":"Primary localized amyloidosis presenting as diffuse amorphous calcified mass in both orbits: case report","volume":"74","author":"Gon\u00e7alves AC","year":"2011","journal-title":"Arq Bras Oftalmol"},{"issue":"3","key":"ref9","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/S0039-6257(99)00101-0","article-title":"Nonthyroid causes of extraocular muscle disease","volume":"44","author":"Lacey B","year":"1999","journal-title":"Surv Ophthalmol"},{"issue":"1","key":"ref10","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1136\/bjo.71.1.32","article-title":"Primary orbital amyloidosis localised to an extraocular muscle","volume":"71","author":"Holmstr\u00f6m GE","year":"1987","journal-title":"Br J Ophthalmol"}],"container-title":["Einstein (S\u00e3o Paulo)"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/eins\/v14n4\/1679-4508-eins-14-04-0553.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,4,28]],"date-time":"2017-04-28T20:23:21Z","timestamp":1493411001000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S1679-45082016000400553&lng=en&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,12]]},"references-count":10,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2016,12]]}},"alternative-id":["S1679-45082016000400553"],"URL":"https:\/\/doi.org\/10.1590\/s1679-45082016rc3744","relation":{},"ISSN":["1679-4508"],"issn-type":[{"type":"electronic","value":"1679-4508"}],"subject":[],"published":{"date-parts":[[2016,12]]}}}