ENDOCRINE OPHTHALMOPATHY IN A PATIENT UNDER CONTINUOUS IMMUNOSUPPRESSIVE THERAPY AFTER CARDIAC TRANSPLANTATION

We present the case of a female patient who has been on immunosuppress ive therapy consisting of cyclosporin A and prednisolone for 9 years b ecause of heterotopic (auxiliary) heart transplantation in 1984, In 19 92 the patient developed Graves' disease followed by endocrine ophthal mopathy class IV 1 year later, To our knowledge this is the first repo rt on Graves' disease with subsequent severe endocrine ophthalmopathy in a patient under immunosuppressive treatment with cyclosporin A and prednisolone in doses that effectively prevent heart transplant reject ion, Prednisolone, which is used as a first line treatment of endocrin e ophthalmopathy, and cyclosporin A, both inhibit T cell function, How ever, in this patient they were not effective in preventing the develo pment of Graves' disease with subsequent endocrine ophthalmopathy, bot h of which are autoimmune diseases.