An update on thyroid-associated ophthalmopathy in children and adolescents

Abstract

Background: Risk of developing thyroid-associated ophthalmopathy (TAO) in children and adolescents is similar or may be even slightly higher than in adults. The aim of this article is to review and summarize current knowledge regarding diagnostic and therapeutic measures in pediatric TAO.

Thyrotoxic crisis as an acute clinical presentation in a child

“…This is an autoimmune disorder where the thyroid gland is stimulated by autoantibodies. Another feature of thyrotoxicosis, especially with GD, is the thyroid eye disease 6. This is less common in children than in adults and usually presents with a mild form of proptosis and soft tissue swelling 6.…”

“…Another feature of thyrotoxicosis, especially with GD, is the thyroid eye disease 6. This is less common in children than in adults and usually presents with a mild form of proptosis and soft tissue swelling 6. It should be noted that one important differential would be hashitoxicosis.…”

Retrospective Review of Pediatric Thyroid Eye Disease Cases Referred to Nicklaus Children's Hospital

“…[1][2][3] As in adults, TED is most often associated with acquired hyperthyroidism, but may occur in hypothyroid and euthyroid states as well. 4 One-third of children with Graves' disease develop ophthalmopathy, with a median time of one month from diagnosis of Graves' disease until development of TED, although 82% of children had ocular complaints prior to being diagnosis in a study by Jarusaitiene et al 2,5 Two-thirds of children with TED are between the ages of 11 and 18 years, presumably due to an increased prevalence of smoking in this age group. 2 Although postpubertal children seem to experience more serious complications, signs of TED are generally mild and self-resolving, potentially delaying diagnosis.…”

“…2 Although postpubertal children seem to experience more serious complications, signs of TED are generally mild and self-resolving, potentially delaying diagnosis. 1,4 Common manifestations noted in the literature include upper eyelid retraction, proptosis, eyelid lag, pain, foreign body sensation, photosensitivity, tearing, and diplopia, while optic neuropathy and corneal breakdown are infrequent. 4 In addition, myopia may accompany proptosis.…”

“…1,4 Common manifestations noted in the literature include upper eyelid retraction, proptosis, eyelid lag, pain, foreign body sensation, photosensitivity, tearing, and diplopia, while optic neuropathy and corneal breakdown are infrequent. 4 In addition, myopia may accompany proptosis. 4 In contrast to children, adults with Graves 'ophthalmopathy seem to experience more severe disease manifestations, with higher rates of exophthalmos, restrictive myopathy, and optic nerve dysfunction.…”