https://www.selleckchem.com/products/SGX-523.html 6 g/L β-alanine with a product/catalyst (P/C) ratio of 5.9 g/g and a conversion > 99%. These results showed that reshaping the protonation conformation of PanD can efficiently relieve mechanism-based inactivation and boost catalytic stability. © 2020 Wiley Periodicals, Inc.INTRODUCTION The management of patients with Graves' orbitopathy (GO) and severe dysthyroid optic neuropathy (DON), refractory to corticosteroid therapy and radiation therapy is a major challenge. As T cells infiltrate in orbital tissues plays a central role in the pathogenesis of GO, the administration of rabbit anti-thymocyte globulin (rATG) may be considered as a potential new method of therapy. CASE PRESENTATION We present a case of the woman with 25-years history of Graves-Basedow disease, treated with subtotal strumectomy, two courses of radioiodine therapy, who developed severe DON during glucocorticoid therapy according to EUGOGO protocol for GO with a prompt application of orbital radiotherapy and ineffective re-administration of glucocorticoid methylprednisolone. The patient received an experimental therapy with rATG (two doses of 1.5 mg/kg). The clinical improvement in GO was noted at 6-week examination after rATG administration. The improvement in GO and DON, confirmed by pattern visual evoked potentials (PVEP), continued a year after administration, in parallel to the normalization of CD4/CD8 ratio of peripheral blood T lymphocytes. CONCLUSIONS Thymoglobulin may be useful in the management of severe steroid-resistant GO with dysthyroid optic neuropathy. The effectiveness of this new therapy requires a larger number of observations.Synchronous existence of medullary and papillary thyroid carcinoma is an extremely rare occurrence; however, it has been previously reported. Nonetheless, such coexistence combined with the absence of primary tumor lesions of either of the two carcinomas has never been reported. In our case, a 34-year old mal