{"id":1045,"date":"2019-07-06T08:19:10","date_gmt":"2019-07-06T06:19:10","guid":{"rendered":"http:\/\/geremi.fr\/?p=1045"},"modified":"2020-01-02T07:18:55","modified_gmt":"2020-01-02T06:18:55","slug":"orbitopathie_dysthyroidienne_1","status":"publish","type":"post","link":"https:\/\/geremi.fr\/index.php\/2019\/07\/06\/orbitopathie_dysthyroidienne_1\/","title":{"rendered":"Orbitopathie dysthyro\u00efdienne (1)"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row][vc_column][vc_column_text]<strong>Observation<\/strong><\/p>\n<p><strong><u><\/u>TDM sans injection en coupes axiale et coronale<\/strong><\/p>\n<p>Pr\u00e9sence de gros muscles droits (m\u00e9dial, lat\u00e9ral, sup\u00e9rieur et inf\u00e9rieur) aux deux yeux. Exophtalmie \u0153il droit grade 2, exophtalmie grade 1 pour l\u2019\u0153il gauche (suivant la ligne bicanthale externe). Hypertrophie de l\u2019ensemble des muscles oculomoteurs compatibles avec une maladie de Basedow. Epaississement diffus des muscles oculomoteurs pr\u00e9 dominants sur le droit m\u00e9dial et inf\u00e9rieur<\/p>\n<p><strong>Photos<\/strong><\/p>\n<p>\u0152d\u00e8me palp\u00e9bral bilat\u00e9ral avec signes d\u2019inflammation orbitaire (score CAS pour Clinical Activity Score &gt; 3 de l\u2019EUGOGO, ici = 5\/7) avec ch\u00e9mosis, hyperh\u00e9mie caronculaire notamment. Pr\u00e9sence d\u2019une k\u00e9ratite ponctu\u00e9e superficielle visible en lampe \u00e0 fente portable avec test \u00e0 la fluoresc\u00e9ine (d\u2019o\u00f9 les traces oranges sur le pourtour des paupi\u00e8res), t\u00e9moigne de la s\u00e9v\u00e9rit\u00e9 de l\u2019atteinte.<\/p>\n<p>[\/vc_column_text]<div id=\"69fc8b5ae47cc\" class=\"gg_gallery_wrap gg_true_gallery gg_standard_gallery gid_1043 ggom_13  ggom_txt_vis ggom_hide_all\"  data-gid=\"1043\" data-nores-txt=\"No images found\">              <div class=\"gg_loader\">            <div class=\"ggl_1\"><\/div>            <div class=\"ggl_2\"><\/div>            <div class=\"ggl_3\"><\/div>            <div class=\"ggl_4\"><\/div>        <\/div>  <div class=\"gg_container\"><div class=\"gg_img \" data-gg-url=\"https:\/\/drive.google.com\/uc?id=1e3PUGFBK6wa4ylJBfTvxX-W0vejjE05_\" data-gg-title=\"TDM coupe axiale.png\" data-gg-author=\"Sacha NAHON\" data-gg-descr=\"TDM sans injection en coupes axiale et coronale avec pr\u00e9sence de gros muscles droits (m\u00e9dial, lat\u00e9ral, sup\u00e9rieur et inf\u00e9rieur) aux deux yeux. Exophtalmie \u0153il droit grade 2, exophtalmie grade 1 pour l\u2019\u0153il gauche (suivant la ligne bicanthale externe). Hypertrophie de l\u2019ensemble des muscles oculomoteurs compatibles avec une maladie de Basedow. Epaississement diffus des muscles oculomoteurs pr\u00e9 dominants sur le droit m\u00e9dial et inf\u00e9rieur.\" data-gg-tags=\"\" data-img-id=\"0\" data-gid=\"1043\">  <div class=\"gg_img_inner\"><div class=\"gg_main_img_wrap\"><img decoding=\"async\" src=\"\" data-gg-lazy-src=\"\/\/geremi.fr\/wp-content\/uploads\/ewpt_cache\/250x200_100_1_c_FFFFFF_62172ec992434021be9669c7181c7474.jpg\" alt=\"TDM coupe axiale.png\" class=\"gg_photo gg_main_thumb\" \/><noscript><img decoding=\"async\" src=\"https:\/\/drive.google.com\/uc?id=1e3PUGFBK6wa4ylJBfTvxX-W0vejjE05_\" alt=\"TDM coupe axiale.png\" \/><\/noscript><\/div><div class=\"gg_overlays\"><div class=\"ggom_layer ggom_corner_slice ggom_13_1 ggom_bottom-left\"><\/div><div class=\"ggom_txt_wrap ggom_13_4 \"><div class=\"ggom_layer ggom_button ggom_13_2\">+<\/div><div class=\"ggom_layer ggom_txt_block ggom_13_3\"><\/div><\/div><\/div><\/div><\/div><div class=\"gg_img \" data-gg-url=\"https:\/\/drive.google.com\/uc?id=10wZ4tTJJr8JQXXgOCHEHbb3Esyj_afVj\" data-gg-title=\"TDM coupe coronale.png\" data-gg-author=\"Sacha NAHON\" data-gg-descr=\"TDM sans injection en coupes axiale et coronale avec pr\u00e9sence de gros muscles droits (m\u00e9dial, lat\u00e9ral, sup\u00e9rieur et inf\u00e9rieur) aux deux yeux. Exophtalmie \u0153il droit grade 2, exophtalmie grade 1 pour l\u2019\u0153il gauche (suivant la ligne bicanthale externe). Hypertrophie de l\u2019ensemble des muscles oculomoteurs compatibles avec une maladie de Basedow. Epaississement diffus des muscles oculomoteurs pr\u00e9 dominants sur le droit m\u00e9dial et inf\u00e9rieur.\" data-gg-tags=\"\" data-img-id=\"1\" data-gid=\"1043\">  <div class=\"gg_img_inner\"><div class=\"gg_main_img_wrap\"><img decoding=\"async\" src=\"\" data-gg-lazy-src=\"\/\/geremi.fr\/wp-content\/uploads\/ewpt_cache\/250x200_100_1_c_FFFFFF_3b3d7d4ee3280e9bb1c984f89767b706.jpg\" alt=\"TDM coupe coronale.png\" class=\"gg_photo gg_main_thumb\" \/><noscript><img decoding=\"async\" src=\"https:\/\/drive.google.com\/uc?id=10wZ4tTJJr8JQXXgOCHEHbb3Esyj_afVj\" alt=\"TDM coupe coronale.png\" \/><\/noscript><\/div><div class=\"gg_overlays\"><div class=\"ggom_layer ggom_corner_slice ggom_13_1 ggom_bottom-left\"><\/div><div class=\"ggom_txt_wrap ggom_13_4 \"><div class=\"ggom_layer ggom_button ggom_13_2\">+<\/div><div class=\"ggom_layer ggom_txt_block ggom_13_3\"><\/div><\/div><\/div><\/div><\/div><div class=\"gg_img \" data-gg-url=\"https:\/\/drive.google.com\/uc?id=1ictrDGjAGbkC1cN-PwI-zNhtM8zGLGpv\" data-gg-title=\"position primaire.png\" data-gg-author=\"Sacha NAHON\" data-gg-descr=\"\u0152d\u00e8me palp\u00e9bral bilat\u00e9ral avec signes d\u2019inflammation orbitaire (score CAS pour Clinical Activity Score &gt; 3 de l\u2019EUGOGO, ici = 5\/7) avec ch\u00e9mosis, hyperh\u00e9mie caronculaire notamment. Pr\u00e9sence d\u2019une k\u00e9ratite ponctu\u00e9e superficielle visible en lampe \u00e0 fente portable avec test \u00e0 la fluoresc\u00e9ine (d\u2019o\u00f9 les traces oranges sur le pourtour des paupi\u00e8res), t\u00e9moigne de la s\u00e9v\u00e9rit\u00e9 de l\u2019atteinte.\" data-gg-tags=\"\" data-img-id=\"2\" data-gid=\"1043\">  <div class=\"gg_img_inner\"><div class=\"gg_main_img_wrap\"><img decoding=\"async\" src=\"\" data-gg-lazy-src=\"\/\/geremi.fr\/wp-content\/uploads\/ewpt_cache\/250x200_100_1_c_FFFFFF_dd5dbf28ea4fae3bb78e92efa639b766.jpg\" alt=\"position primaire.png\" class=\"gg_photo gg_main_thumb\" \/><noscript><img decoding=\"async\" src=\"https:\/\/drive.google.com\/uc?id=1ictrDGjAGbkC1cN-PwI-zNhtM8zGLGpv\" alt=\"position primaire.png\" \/><\/noscript><\/div><div class=\"gg_overlays\"><div class=\"ggom_layer ggom_corner_slice ggom_13_1 ggom_bottom-left\"><\/div><div class=\"ggom_txt_wrap ggom_13_4 \"><div class=\"ggom_layer ggom_button ggom_13_2\">+<\/div><div class=\"ggom_layer ggom_txt_block ggom_13_3\"><\/div><\/div><\/div><\/div><\/div><div class=\"gg_img \" data-gg-url=\"https:\/\/drive.google.com\/uc?id=1L5YQIq4PsAUAhmACZjR8r8v5rXAQav2p\" data-gg-title=\"position ferm\u00e9e.png\" data-gg-author=\"Sacha NAHON\" data-gg-descr=\"\u0152d\u00e8me palp\u00e9bral bilat\u00e9ral avec signes d\u2019inflammation orbitaire (score CAS pour Clinical Activity Score &gt; 3 de l\u2019EUGOGO, ici = 5\/7) avec ch\u00e9mosis, hyperh\u00e9mie caronculaire notamment. Pr\u00e9sence d\u2019une k\u00e9ratite ponctu\u00e9e superficielle visible en lampe \u00e0 fente portable avec test \u00e0 la fluoresc\u00e9ine (d\u2019o\u00f9 les traces oranges sur le pourtour des paupi\u00e8res), t\u00e9moigne de la s\u00e9v\u00e9rit\u00e9 de l\u2019atteinte.\" data-gg-tags=\"\" data-img-id=\"3\" data-gid=\"1043\">  <div class=\"gg_img_inner\"><div class=\"gg_main_img_wrap\"><img decoding=\"async\" src=\"\" data-gg-lazy-src=\"\/\/geremi.fr\/wp-content\/uploads\/ewpt_cache\/250x200_100_1_c_FFFFFF_e62cc73b98a13ca77065168fcf85b1d4.jpg\" alt=\"position ferm\u00e9e.png\" class=\"gg_photo gg_main_thumb\" \/><noscript><img decoding=\"async\" src=\"https:\/\/drive.google.com\/uc?id=1L5YQIq4PsAUAhmACZjR8r8v5rXAQav2p\" alt=\"position ferm\u00e9e.png\" \/><\/noscript><\/div><div class=\"gg_overlays\"><div class=\"ggom_layer ggom_corner_slice ggom_13_1 ggom_bottom-left\"><\/div><div class=\"ggom_txt_wrap ggom_13_4 \"><div class=\"ggom_layer ggom_button ggom_13_2\">+<\/div><div class=\"ggom_layer ggom_txt_block ggom_13_3\"><\/div><\/div><\/div><\/div><\/div><div class=\"gg_img \" data-gg-url=\"https:\/\/drive.google.com\/uc?id=1Fp4Jm0uqF8qPAYZXjfrw2LQ-1Nf2dd2Z\" data-gg-title=\"ouverture forc\u00e9e.png\" data-gg-author=\"Sacha NAHON\" data-gg-descr=\"\u0152d\u00e8me palp\u00e9bral bilat\u00e9ral avec signes d\u2019inflammation orbitaire (score CAS pour Clinical Activity Score &gt; 3 de l\u2019EUGOGO, ici = 5\/7) avec ch\u00e9mosis, hyperh\u00e9mie caronculaire notamment. Pr\u00e9sence d\u2019une k\u00e9ratite ponctu\u00e9e superficielle visible en lampe \u00e0 fente portable avec test \u00e0 la fluoresc\u00e9ine (d\u2019o\u00f9 les traces oranges sur le pourtour des paupi\u00e8res), t\u00e9moigne de la s\u00e9v\u00e9rit\u00e9 de l\u2019atteinte.\" data-gg-tags=\"\" data-img-id=\"4\" data-gid=\"1043\">  <div class=\"gg_img_inner\"><div class=\"gg_main_img_wrap\"><img decoding=\"async\" src=\"\" data-gg-lazy-src=\"\/\/geremi.fr\/wp-content\/uploads\/ewpt_cache\/250x200_100_1_c_FFFFFF_94270dc143c1338b16fe55821027f858.jpg\" alt=\"ouverture forc\u00e9e.png\" class=\"gg_photo gg_main_thumb\" \/><noscript><img decoding=\"async\" src=\"https:\/\/drive.google.com\/uc?id=1Fp4Jm0uqF8qPAYZXjfrw2LQ-1Nf2dd2Z\" alt=\"ouverture forc\u00e9e.png\" \/><\/noscript><\/div><div class=\"gg_overlays\"><div class=\"ggom_layer ggom_corner_slice ggom_13_1 ggom_bottom-left\"><\/div><div class=\"ggom_txt_wrap ggom_13_4 \"><div class=\"ggom_layer ggom_button ggom_13_2\">+<\/div><div class=\"ggom_layer ggom_txt_block ggom_13_3\"><\/div><\/div><\/div><\/div><\/div><\/div><div style=\"clear: both;\"><\/div><\/div><script type=\"text\/javascript\">     (function() {         \"use strict\";              const intval = setInterval(() => {            if(typeof(jQuery) == \"undefined\" || typeof(gg_galleries_init) == \"undefined\") {                return true;            }            else {                clearTimeout(intval);                            const $ = jQuery;                gg_galleries_init(\"69fc8b5ae47cc\");            }        }, 50);    })();<\/script>[vc_column_text]<strong>Histoire de la maladie<br \/>\n<\/strong>Patient de 55 ans adress\u00e9 pour bilan d\u2019an\u00e9mie avec \u00ab \u0153d\u00e8me du visage \u00bb. Grabataire, symptomatologie chronique, r\u00e9f\u00e9r\u00e9 au CHU en urgence pour ce motif. Diagnostic clinique d\u2019orbitopathie dysthyro\u00efdienne, confirm\u00e9 au scanner du fait des constatations. Un bilan en endocrinologie est effectu\u00e9. L\u2019\u00e9tat clinique est \u00e9vocateur d\u2019un hypopituitarisme confirm\u00e9 par le bilan biologique avec insuffisance gonadotrope, corticotrope et somatotrope. Axe thyr\u00e9otrope et \u00e9chographie thyro\u00efdienne sans anomalie. L\u2019ECG a retrouv\u00e9 un rythme irr\u00e9gulier et non sinusal avec trouble de la repolarisation. Une suppl\u00e9mentation par hydrocortisone est d\u00e9but\u00e9e du fait de l\u2019insuffisance corticotrope. Exploration an\u00e9mie par FODG +\/- coloscopie et prise en charge cardiologique pour le trouble du rythme. La maladie de Basedow n\u2019est pas retenue pour le moment malgr\u00e9 une description clinique quasi-pathognomonique.<\/p>\n<p><em><u>Ant\u00e9c\u00e9dents<\/u><\/em>\u00a0: retard psychomoteur et \u00e9pilepsie sur trauma cr\u00e2nien dans l\u2019enfance<br \/>\n<em><u>Traitements<\/u><\/em>\u00a0: bisoce, coversyl, depakine, eupantol, loxapac, movicol, risperdone, tardyferon, dafalgan, smecta<\/p>\n<p><strong>Ex ophtalmo<br \/>\n<\/strong>Motilit\u00e9 oculaire : quasi-ophtalmopl\u00e9gie compl\u00e8te dans toutes les positions du regard<br \/>\nGlobes d\u00e9pressibles, r\u00e9ductibles, non tendus<br \/>\nLAF : k\u00e9ratite ponctu\u00e9e superficielle inf\u00e9rieure \u00e0 droite, corn\u00e9e fluoresc\u00e9ine n\u00e9gative \u00e0 gauche. Segment ant\u00e9rieur calme profond avec cataracte d\u00e9butante aux deux yeux.<br \/>\nPIO = 20 mmHg ODG<br \/>\nFO : normal aux deux yeux (pas d\u2019\u0153d\u00e8me papillaire ni p\u00e2leur)<\/p>\n<p><strong>Ex g\u00e9n\u00e9ral<br \/>\n<\/strong>Etat g\u00e9n\u00e9ral pr\u00e9caire avec troubles cognitifs s\u00e9v\u00e8res s\u00e9quellaires d\u2019un AVP. Pas de contact possible. Tableau clinique \u00e9voquant un hypopituitarisme : d\u00e9pilation, peau fine et tr\u00e8s p\u00e2le, hypotonie et somnolence.<\/p>\n<p><strong>Ex compl\u00e9mentaires<\/strong><\/p>\n<p><strong>Biologie<\/strong><\/p>\n<table style=\"height: 495px;\" width=\"787\">\n<tbody>\n<tr>\n<td width=\"153\"><strong>Bilan h\u00e9matologique<\/strong><\/p>\n<p>GB \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 5.6<br \/>\nHb \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 8.3<br \/>\nVGM \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 83<br \/>\nPlaquettes \u00a0\u00a0\u00a0\u00a0 169<br \/>\nCRP \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 31.9<\/td>\n<td width=\"153\"><strong>Bilan m\u00e9tabolique<\/strong><\/p>\n<p>HbA1C 4.5%<br \/>\nGlyc \u00a0\u00a0\u00a0 0.82 g\/l<br \/>\nCT \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 1.15 g\/l<br \/>\nTG \u00a0\u00a0\u00a0\u00a0\u00a0 1.36 g\/l<br \/>\nHDL \u00a0\u00a0\u00a0 0.19 g\/l<br \/>\nLDL \u00a0\u00a0\u00a0\u00a0 0.68 g\/l<\/td>\n<td width=\"153\"><strong>Bilan thyro\u00efdien<\/strong><\/p>\n<p>T4L \u00a0\u00a0\u00a0\u00a0 14.1 pmol\/l<br \/>\nTSH \u00a0\u00a0\u00a0 1.96 mUI\/l<br \/>\nT3L \u00a0\u00a0\u00a0\u00a0 3.64 pmol\/l<br \/>\nAc anti-r\u00e9cept. TSH &lt;1 U\/l<br \/>\nAc anti-TPO &lt; 28 UI\/ml<\/td>\n<td width=\"153\"><strong>Bilan h\u00e9patique<\/strong><\/p>\n<p>ASAT \u00a0 40<br \/>\nALAT \u00a0 18<br \/>\nGGT \u00a0\u00a0\u00a0 19<br \/>\nPh Alc 78<br \/>\nFerritine 284 \u00b5g\/l<\/td>\n<\/tr>\n<tr>\n<td width=\"153\"><strong>Bilan r\u00e9nal<\/strong><\/p>\n<p>Na+ \u00a0\u00a0\u00a0 141<br \/>\nCl Cr\u00e9at 101<br \/>\nK+ \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 4.2<br \/>\nCr\u00e9atinine 70 \u00b5mol\/l<\/td>\n<td width=\"153\"><strong>Bilan corticotrope<\/strong><\/p>\n<p>Temps\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 T0<br \/>\nCortisol\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0 &lt;10<br \/>\nACTH\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a012<\/td>\n<td width=\"153\"><strong>Bilan phosphocalcique<\/strong><\/p>\n<p>PTH \u00a0\u00a0\u00a0 106 ng\/l<br \/>\nCa \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 2.21 mmol\/l<br \/>\nPh \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 1.09 mmol\/l<br \/>\n25OH D3 \u00a0\u00a0\u00a0\u00a016 ng\/l<\/td>\n<td width=\"153\"><strong>Bilan gonadotrope<\/strong><\/p>\n<p>FSH \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 0.9<br \/>\nLH \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 2.0<br \/>\nTesto \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 &lt;0.07<br \/>\nProlactine \u00a0\u00a0\u00a0\u00a0\u00a0 30.1<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>Autres r\u00e9sultats biologiques<\/strong><\/p>\n<p>Troponine \u00a0 \u00a0 \u00a0&lt;17<br \/>\nBNP \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 69<br \/>\nIGF 1 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a010<\/p>\n<p><strong>ECG<br \/>\n<\/strong>rythme non sinusal et irr\u00e9gulier \u00e0 71\/min. QRS fins. Onde T plate de V1 \u00e0 V6, onde T n\u00e9gative en D2 D3 AVF.<\/p>\n<p><strong>Echographie de la thyro\u00efde<br \/>\n<\/strong>Lobe droit : 41*14*13 mm. Volume de 4.1 cc. Lobe gauche : 37*8*14 mm. Volume 2.4 cc. Pas de nodule.<\/p>\n<p><strong>R\u00e9flexes pour le DFASM<br \/>\n<\/strong>\u00c9voquer l\u2019orbitopathie dysthyro\u00efdienne devant un tel tableau clinique.<br \/>\nSavoir analyser les axes hypophysaires.<\/p>\n<p><strong>Auteur<br \/>\n<\/strong>Sacha NAHON[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>[vc_row][vc_column][vc_column_text]Observation TDM sans injection en coupes axiale et coronale Pr\u00e9sence de gros muscles droits (m\u00e9dial, lat\u00e9ral, sup\u00e9rieur et inf\u00e9rieur) aux deux yeux. Exophtalmie \u0153il droit grade 2, exophtalmie grade 1 pour l\u2019\u0153il gauche (suivant la <a class=\"mh-excerpt-more\" href=\"https:\/\/geremi.fr\/index.php\/2019\/07\/06\/orbitopathie_dysthyroidienne_1\/\" title=\"Orbitopathie dysthyro\u00efdienne (1)\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":1511,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[648],"tags":[1164],"discipline":[1200],"class_list":{"0":"post-1045","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-648","8":"tag-dossier","9":"discipline-ophtalmologie"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Orbitopathie dysthyro\u00efdienne (1) - GeReMI<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/geremi.fr\/index.php\/2019\/07\/06\/orbitopathie_dysthyroidienne_1\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Orbitopathie dysthyro\u00efdienne (1) - GeReMI\" \/>\n<meta property=\"og:description\" content=\"[vc_row][vc_column][vc_column_text]Observation TDM sans injection en coupes axiale et coronale Pr\u00e9sence de gros muscles droits (m\u00e9dial, lat\u00e9ral, sup\u00e9rieur et inf\u00e9rieur) aux deux yeux. Exophtalmie \u0153il droit grade 2, exophtalmie grade 1 pour l\u2019\u0153il gauche (suivant la [...]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/geremi.fr\/index.php\/2019\/07\/06\/orbitopathie_dysthyroidienne_1\/\" \/>\n<meta property=\"og:site_name\" content=\"GeReMI\" \/>\n<meta property=\"article:published_time\" content=\"2019-07-06T06:19:10+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2020-01-02T06:18:55+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/geremi.fr\/wp-content\/uploads\/2019\/07\/dreamstime_xs_56253338.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"480\" \/>\n\t<meta property=\"og:image:height\" content=\"480\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"admin2767\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"\u00c9crit par\" \/>\n\t<meta name=\"twitter:data1\" content=\"admin2767\" \/>\n\t<meta name=\"twitter:label2\" content=\"Dur\u00e9e de lecture estim\u00e9e\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/geremi.fr\\\/index.php\\\/2019\\\/07\\\/06\\\/orbitopathie_dysthyroidienne_1\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/geremi.fr\\\/index.php\\\/2019\\\/07\\\/06\\\/orbitopathie_dysthyroidienne_1\\\/\"},\"author\":{\"name\":\"admin2767\",\"@id\":\"https:\\\/\\\/geremi.fr\\\/#\\\/schema\\\/person\\\/8e474f355e10a8861470d9f812c74aed\"},\"headline\":\"Orbitopathie dysthyro\u00efdienne (1)\",\"datePublished\":\"2019-07-06T06:19:10+00:00\",\"dateModified\":\"2020-01-02T06:18:55+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/geremi.fr\\\/index.php\\\/2019\\\/07\\\/06\\\/orbitopathie_dysthyroidienne_1\\\/\"},\"wordCount\":623,\"image\":{\"@id\":\"https:\\\/\\\/geremi.fr\\\/index.php\\\/2019\\\/07\\\/06\\\/orbitopathie_dysthyroidienne_1\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/geremi.fr\\\/wp-content\\\/uploads\\\/2019\\\/07\\\/dreamstime_xs_56253338.jpg\",\"keywords\":[\"Dossier\"],\"articleSection\":[\"240. Hyperthyro\u00efdie\"],\"inLanguage\":\"fr-FR\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/geremi.fr\\\/index.php\\\/2019\\\/07\\\/06\\\/orbitopathie_dysthyroidienne_1\\\/\",\"url\":\"https:\\\/\\\/geremi.fr\\\/index.php\\\/2019\\\/07\\\/06\\\/orbitopathie_dysthyroidienne_1\\\/\",\"name\":\"Orbitopathie dysthyro\u00efdienne (1) - GeReMI\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/geremi.fr\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/geremi.fr\\\/index.php\\\/2019\\\/07\\\/06\\\/orbitopathie_dysthyroidienne_1\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/geremi.fr\\\/index.php\\\/2019\\\/07\\\/06\\\/orbitopathie_dysthyroidienne_1\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/geremi.fr\\\/wp-content\\\/uploads\\\/2019\\\/07\\\/dreamstime_xs_56253338.jpg\",\"datePublished\":\"2019-07-06T06:19:10+00:00\",\"dateModified\":\"2020-01-02T06:18:55+00:00\",\"author\":{\"@id\":\"https:\\\/\\\/geremi.fr\\\/#\\\/schema\\\/person\\\/8e474f355e10a8861470d9f812c74aed\"},\"breadcrumb\":{\"@id\":\"https:\\\/\\\/geremi.fr\\\/index.php\\\/2019\\\/07\\\/06\\\/orbitopathie_dysthyroidienne_1\\\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/geremi.fr\\\/index.php\\\/2019\\\/07\\\/06\\\/orbitopathie_dysthyroidienne_1\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/geremi.fr\\\/index.php\\\/2019\\\/07\\\/06\\\/orbitopathie_dysthyroidienne_1\\\/#primaryimage\",\"url\":\"https:\\\/\\\/geremi.fr\\\/wp-content\\\/uploads\\\/2019\\\/07\\\/dreamstime_xs_56253338.jpg\",\"contentUrl\":\"https:\\\/\\\/geremi.fr\\\/wp-content\\\/uploads\\\/2019\\\/07\\\/dreamstime_xs_56253338.jpg\",\"width\":480,\"height\":480},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/geremi.fr\\\/index.php\\\/2019\\\/07\\\/06\\\/orbitopathie_dysthyroidienne_1\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Accueil\",\"item\":\"https:\\\/\\\/geremi.fr\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Orbitopathie dysthyro\u00efdienne (1)\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/geremi.fr\\\/#website\",\"url\":\"https:\\\/\\\/geremi.fr\\\/\",\"name\":\"GeReMI\",\"description\":\"Gestion des Ressources Multimedia pour l&#039;Internat\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/geremi.fr\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"fr-FR\"},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/geremi.fr\\\/#\\\/schema\\\/person\\\/8e474f355e10a8861470d9f812c74aed\",\"name\":\"admin2767\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/dc3a2eb3f8d14b9d874223b39d7a5137e36df9768fc8455b26f7be4b82457af6?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/dc3a2eb3f8d14b9d874223b39d7a5137e36df9768fc8455b26f7be4b82457af6?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/dc3a2eb3f8d14b9d874223b39d7a5137e36df9768fc8455b26f7be4b82457af6?s=96&d=mm&r=g\",\"caption\":\"admin2767\"}}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Orbitopathie dysthyro\u00efdienne (1) - GeReMI","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/geremi.fr\/index.php\/2019\/07\/06\/orbitopathie_dysthyroidienne_1\/","og_locale":"fr_FR","og_type":"article","og_title":"Orbitopathie dysthyro\u00efdienne (1) - GeReMI","og_description":"[vc_row][vc_column][vc_column_text]Observation TDM sans injection en coupes axiale et coronale Pr\u00e9sence de gros muscles droits (m\u00e9dial, lat\u00e9ral, sup\u00e9rieur et inf\u00e9rieur) aux deux yeux. Exophtalmie \u0153il droit grade 2, exophtalmie grade 1 pour l\u2019\u0153il gauche (suivant la [...]","og_url":"https:\/\/geremi.fr\/index.php\/2019\/07\/06\/orbitopathie_dysthyroidienne_1\/","og_site_name":"GeReMI","article_published_time":"2019-07-06T06:19:10+00:00","article_modified_time":"2020-01-02T06:18:55+00:00","og_image":[{"width":480,"height":480,"url":"https:\/\/geremi.fr\/wp-content\/uploads\/2019\/07\/dreamstime_xs_56253338.jpg","type":"image\/jpeg"}],"author":"admin2767","twitter_card":"summary_large_image","twitter_misc":{"\u00c9crit par":"admin2767","Dur\u00e9e de lecture estim\u00e9e":"3 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/geremi.fr\/index.php\/2019\/07\/06\/orbitopathie_dysthyroidienne_1\/#article","isPartOf":{"@id":"https:\/\/geremi.fr\/index.php\/2019\/07\/06\/orbitopathie_dysthyroidienne_1\/"},"author":{"name":"admin2767","@id":"https:\/\/geremi.fr\/#\/schema\/person\/8e474f355e10a8861470d9f812c74aed"},"headline":"Orbitopathie dysthyro\u00efdienne (1)","datePublished":"2019-07-06T06:19:10+00:00","dateModified":"2020-01-02T06:18:55+00:00","mainEntityOfPage":{"@id":"https:\/\/geremi.fr\/index.php\/2019\/07\/06\/orbitopathie_dysthyroidienne_1\/"},"wordCount":623,"image":{"@id":"https:\/\/geremi.fr\/index.php\/2019\/07\/06\/orbitopathie_dysthyroidienne_1\/#primaryimage"},"thumbnailUrl":"https:\/\/geremi.fr\/wp-content\/uploads\/2019\/07\/dreamstime_xs_56253338.jpg","keywords":["Dossier"],"articleSection":["240. Hyperthyro\u00efdie"],"inLanguage":"fr-FR"},{"@type":"WebPage","@id":"https:\/\/geremi.fr\/index.php\/2019\/07\/06\/orbitopathie_dysthyroidienne_1\/","url":"https:\/\/geremi.fr\/index.php\/2019\/07\/06\/orbitopathie_dysthyroidienne_1\/","name":"Orbitopathie dysthyro\u00efdienne (1) - GeReMI","isPartOf":{"@id":"https:\/\/geremi.fr\/#website"},"primaryImageOfPage":{"@id":"https:\/\/geremi.fr\/index.php\/2019\/07\/06\/orbitopathie_dysthyroidienne_1\/#primaryimage"},"image":{"@id":"https:\/\/geremi.fr\/index.php\/2019\/07\/06\/orbitopathie_dysthyroidienne_1\/#primaryimage"},"thumbnailUrl":"https:\/\/geremi.fr\/wp-content\/uploads\/2019\/07\/dreamstime_xs_56253338.jpg","datePublished":"2019-07-06T06:19:10+00:00","dateModified":"2020-01-02T06:18:55+00:00","author":{"@id":"https:\/\/geremi.fr\/#\/schema\/person\/8e474f355e10a8861470d9f812c74aed"},"breadcrumb":{"@id":"https:\/\/geremi.fr\/index.php\/2019\/07\/06\/orbitopathie_dysthyroidienne_1\/#breadcrumb"},"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/geremi.fr\/index.php\/2019\/07\/06\/orbitopathie_dysthyroidienne_1\/"]}]},{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/geremi.fr\/index.php\/2019\/07\/06\/orbitopathie_dysthyroidienne_1\/#primaryimage","url":"https:\/\/geremi.fr\/wp-content\/uploads\/2019\/07\/dreamstime_xs_56253338.jpg","contentUrl":"https:\/\/geremi.fr\/wp-content\/uploads\/2019\/07\/dreamstime_xs_56253338.jpg","width":480,"height":480},{"@type":"BreadcrumbList","@id":"https:\/\/geremi.fr\/index.php\/2019\/07\/06\/orbitopathie_dysthyroidienne_1\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Accueil","item":"https:\/\/geremi.fr\/"},{"@type":"ListItem","position":2,"name":"Orbitopathie dysthyro\u00efdienne (1)"}]},{"@type":"WebSite","@id":"https:\/\/geremi.fr\/#website","url":"https:\/\/geremi.fr\/","name":"GeReMI","description":"Gestion des Ressources Multimedia pour l&#039;Internat","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/geremi.fr\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"fr-FR"},{"@type":"Person","@id":"https:\/\/geremi.fr\/#\/schema\/person\/8e474f355e10a8861470d9f812c74aed","name":"admin2767","image":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/secure.gravatar.com\/avatar\/dc3a2eb3f8d14b9d874223b39d7a5137e36df9768fc8455b26f7be4b82457af6?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/dc3a2eb3f8d14b9d874223b39d7a5137e36df9768fc8455b26f7be4b82457af6?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/dc3a2eb3f8d14b9d874223b39d7a5137e36df9768fc8455b26f7be4b82457af6?s=96&d=mm&r=g","caption":"admin2767"}}]}},"_links":{"self":[{"href":"https:\/\/geremi.fr\/index.php\/wp-json\/wp\/v2\/posts\/1045","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/geremi.fr\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/geremi.fr\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/geremi.fr\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/geremi.fr\/index.php\/wp-json\/wp\/v2\/comments?post=1045"}],"version-history":[{"count":1,"href":"https:\/\/geremi.fr\/index.php\/wp-json\/wp\/v2\/posts\/1045\/revisions"}],"predecessor-version":[{"id":1046,"href":"https:\/\/geremi.fr\/index.php\/wp-json\/wp\/v2\/posts\/1045\/revisions\/1046"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/geremi.fr\/index.php\/wp-json\/wp\/v2\/media\/1511"}],"wp:attachment":[{"href":"https:\/\/geremi.fr\/index.php\/wp-json\/wp\/v2\/media?parent=1045"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/geremi.fr\/index.php\/wp-json\/wp\/v2\/categories?post=1045"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/geremi.fr\/index.php\/wp-json\/wp\/v2\/tags?post=1045"},{"taxonomy":"discipline","embeddable":true,"href":"https:\/\/geremi.fr\/index.php\/wp-json\/wp\/v2\/discipline?post=1045"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}