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This is a case report describing a patient with severe thyroid eye disease complicated with dysthyroid optic neuropathy that was unresponsive to intravenous steroids and orbital radiotherapy but responded well to intravenous tocilizumab.The cases of horseshoe kidney presented by xanthogranulomatous pyelonephritis are very rare. In this study, the case of XGP developing in HSK in a young female patient was presented due to its rare incidence and the previously reported cases were reviewed, as well. The patient, who has end-stage renal disease and was