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Treatment of pretibial myxedema with intralesional immunomodulating therapy

Authors Ren Z, He M, Deng F, Chen Y, Chai L, Chen B, Deng W

Received 11 June 2017

Accepted for publication 11 August 2017

Published 8 September 2017 Volume 2017:13 Pages 1189—1194

DOI https://doi.org/10.2147/TCRM.S143711

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Hoa Le

Peer reviewer comments 2

Editor who approved publication: Professor Deyun Wang

Ziwei Ren,1,* Min He,2,* Fang Deng,2 Yan Chen,1 Liyin Chai,1 Bing Chen,2 Wuquan Deng1

1Department of Endocrinology and Nephrology, Chongqing Emergency Medical Hospital (The Fourth People’s Hospital of Chongqing), 2Department of Endocrinology, Southwest Hospital, Third Military Medical University, Chongqing, People’s Republic of China

*These authors contributed equally to this work

Objective: Local immune regulation therapy has been one of the therapeutic methods used for the treatment of autoimmune thyroid disease in patients with pretibial myxedema (PTM). However, the poor response rate and high recurrence rate are still major problems. Whether a premixed corticosteroid, compound betamethasone, could enhance remission rate and decrease recurrence rate in patients with PTM was investigated in the present study.
Subjects and methods: We have performed a clinical utility observation of compound betamethasone with intralesional injections based on basic thyroid disease treatment in 32 PTM patients between January 2008 and August 2016. The patients were followed up for 2 years, and the clinical outcomes and side effects were calculated and analyzed.
Results: All patients had a complete remission after different times of injection. A total of 21.7% patients had complete remission with one time of injection, 34.8% with two times of injection, 17.4% with three times of injection, 4.3% with four times of injection, and 4.3% with five times of injection. In all, 56.3% patients with a disease duration of <6 months had complete remission after a 1-month treatment, 37.5% patients with a disease duration between 6 months and 12 months had complete remission after a 2-month treatment, 3.1% patients with a disease duration of 2 years had complete remission after a 5-month treatment, and 3.1% with a disease duration of 5 years had complete remission after a 7-month treatment.
Conclusion: Compound betamethasone with multipoint intralesional injection is a feasible, effective, and secure novel strategy in the treatment of PTM.

Keywords: pretibial myxedema, glucocorticoids, compound betamethasone, intralesional injection

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