Abadie's sign of exophthalmic goiter

A clinical sign associated with Graves' disease

Abadie's sign of exophthalmic goiter is a clinical sign that is often associated with Graves' disease, an autoimmune disorder that affects the thyroid gland. This sign is characterized by the spasm or contraction of the levator palpebrae superioris muscle, which results in the retraction of the upper eyelid. This retraction can lead to a characteristic appearance of proptosis, or bulging of the eyes, which is commonly seen in patients with Graves' disease.

Clinical Presentation

Abadie's sign is observed when there is a noticeable retraction of the upper eyelid, which exposes more of the sclera above the iris than is typically visible. This can give the eyes a "staring" appearance. The sign is named after the French neurologist Joseph Louis Irenée Jean Abadie, who described it in the context of exophthalmic goiter.

Pathophysiology

The underlying mechanism of Abadie's sign involves the overactivity of the sympathetic nervous system in patients with Graves' disease. This overactivity leads to increased stimulation of the levator palpebrae superioris muscle, causing the eyelid retraction. The condition is often accompanied by other signs of thyrotoxicosis, such as increased heart rate, weight loss, and tremor.

Diagnosis

The presence of Abadie's sign can be an important clinical clue in the diagnosis of Graves' disease. It is typically assessed during a physical examination of the eyes. The sign is often evaluated in conjunction with other ocular signs of Graves' disease, such as Dalrymple's sign and von Graefe's sign.

Management

Management of Abadie's sign involves treating the underlying Graves' disease. This may include the use of antithyroid drugs, radioactive iodine therapy, or thyroidectomy. In some cases, specific treatments may be required to address the ocular manifestations, such as corticosteroids or orbital decompression surgery.

Related pages

• Graves' disease
• Exophthalmos
• Thyroid eye disease
• Thyrotoxicosis

Gallery

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  Proptosis and lid retraction in Graves' disease

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  Proptosis and lid retraction from Graves' Disease