A 24-year-old woman presented with periorbital pain, progressive diplopia, and restricted eye movement. Routine blood testing was normal except for increased levels of thyroid peroxidase autoantibody (TPOAb) and thyroglobulin autoantibody (TGAb). Orbital computed tomography revealed fusiform thickening of the rectus muscles belly, with tendon sparing, as in thyroid eye disease. Rectus muscle biopsy revealed isolated amyloidosis. Further workup showed no evidence of systemic amyloidosis.
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