Euthyroid and primarily hypothyroid patients develop milder and significantly more asymmetrical Graves ophthalmopathy

Eckstein, Anja; Lösch, Christian; Glowacka, Diana; Schott, M.; Mann, Klaus; Esser, Joachim; Morgenthaler, Nils G.

doi:10.1136/bjo.2007.137265

Cited by 120 publications

(121 citation statements)

References 22 publications

(25 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…25 However, hypothyroidism as primary thyroid dysfunction associated with TED was reported from 0.2 to 8.6% of patients with TED, most of them had autoimmune type of hypothyroidism (Hashimoto's thyroiditis). 1,3,4,9,10,26,27 Although autoantibodies were not checked for all the patients because of unavailability, our endocrinologists believed that Hashimoto's thyroiditis was the main cause of hypothyroidism in this series. Our result of 7.5% Ho-TED is more than what has previously been reported.…”

Section: Resultsmentioning

confidence: 93%

Hyperthyroid vs hypothyroid eye disease: the same severity and activity

Kashkouli

Pakdel

Kiavash

et al. 2011

Eye

View full text Add to dashboard Cite

Purpose To compare demographics, severity, and activity of thyroid eye disease (TED) in patients with hyperthyroidism (Hr-TED) vs primary hypothyroidism (Ho-TED). Patients and MethodsIn a cross-sectional study, demographics, complete eye examination, severity score (NOSPECS, total hundred eye score), clinical activity score, and Rundle grading were recorded for patients with TED and different thyroid disorders referred from an endocrinology clinic from 2003 to 2006. Results TED was clinically found in 303 patients (303/851, 35.6%). The majority of them (280/303, 92.4%) had Graves' hyperthyroidism and 23 (23/303, 7.5%) had primary hypothyroidism. Mean age, gender, mean severity score, mean activity score, Rundle grade, unilateral presentation of TED, smoking habit, mean duration of eye disease, and mean interval time of thyroid to TED were not significantly different between the two groups (0.06oPo0.9). Mean duration of thyroid disease was significantly (P ¼ 0.02) longer in the Hr-TED group (49.6 months) than in the Ho-TED group (22.7 months). Most of the patients in both groups (63.2% of Hr-TED and 73.9% of Ho-TED) developed the eye disease within 18 months before or after the thyroid disease. Conclusion The same demographics, clinical characteristics, and severity and activity scores for Hr-TED and Ho-TED imply that both groups present the same category of eye disease.

show abstract

Section: Resultsmentioning

confidence: 93%

Hyperthyroid vs hypothyroid eye disease: the same severity and activity

Kashkouli

Pakdel

Kiavash

et al. 2011

Eye

View full text Add to dashboard Cite

show abstract

“…Our results also support a previous report that in Asians, TSI measurement is a more sensitive marker of euthyroid TAO than TBII measurements. 10 Among the three patients in whom TBII/TSI assays were negative, the patient presenting with diplopia and unilateral proptosis did not show typical symptoms or signs of orbital myositis such as acute pain exacerbated by eye movement. The CT scan revealed right inferior and medical rectus enlargement without anterior tendon involvement.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9] Because most cases involving euthyroid TAO showed no thyroid abnormalities except testing positive for thyroidstimulating hormone receptor antibodies (TRAbs), 7,9 the clinical significance of TRAb as a criterion in the diagnosis of euthyroid TAO has been suggested. 3,6 Recently, Eckstein et al 10 reported that the TRAb titer was low in euthryoid and hypothyroid patients, suggesting that a more sensitive assay technique was necessary to utilize the TRAb assay for diagnosis of euthyroid/hypothyroid TAO. The TRAb assay used in this report was the thyrotropin-binding inhibitor immunoglobulin (TBII) assay, which cannot discriminate between thyroid-blocking immunoglobulin and thyroidstimulating immunoglobulin (TSI).…”

Section: Introductionmentioning

confidence: 99%

“…The TRAb assay used in this report was the thyrotropin-binding inhibitor immunoglobulin (TBII) assay, which cannot discriminate between thyroid-blocking immunoglobulin and thyroidstimulating immunoglobulin (TSI). Using a secondgeneration TBII assay, Eckstein et al 10 reported that the positive rate of TRAb in the euthyroid/hypothyroid TAO patients was 69%.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical features of thyroid-associated ophthalmopathy in clinically euthyroid Korean patients

Jang

Lee

et al. 2012

Eye

View full text Add to dashboard Cite

Aim To compare clinical characteristics and thyroid-stimulating hormone receptor antibodies (TRAbs) in thyroid-associated ophthalmopathy (TAO) in euthyroid Korean patients with those in hyperthyroid patients. Methods Clinical activity scores (CASs), modified NOSPECS scores, exophthalmometry values, prevalence of optic neuropathy, restrictive myopathy and lid retraction, and the positivity and levels of TRAb (thyrotropin-binding inhibitor immunoglobulin (TBII) and thyroidstimulating immunoglobulin (TSI)) were compared in 24 euthyroid (group A) and 139 clinical/subclinical hyperthyroid TAO patients (group B). Results Group A presented more clinically unilateral involvement than group B (79.2% vs 27.3%, Po0.001), less active (CAS 1.50 vs 2.26, P ¼ 0.014) and less severe clinical course (NOSPECS 3.38 vs 4.13, P ¼ 0.037). Lid retraction was more prevalent in group A than group B (91.7% vs 66.2%, P ¼ 0.014). Prevalence of optic neuropathy and restrictive myopathy, and the mean value of exophthalmometry were not different. Mean TBII levels were lower (7.20 IU/l) in group A than in group B (44.58 IU/l, Po0.001). A similar difference was found in the TSI bioassay (201.40% vs 425.19%, P ¼ 0.001). The positive rate of TBII in group A (34.8%) was significantly lower than in group B (90.8%, Po0.001). The positive rate of TSI was high in both group A (83.3%) and B (91.7%), with no significant difference (P ¼ 0.337).Conclusions Patients with euthyroid TAO showed a less active and severe clinical course, more unilateral involvement, and lower levels of TRAb than those in patients with hyperthyroid TAO. These distinct clinical and biochemical characteristics might be useful in assessment of euthyroid TAO, and the TSI might be more sensitive for diagnosing these patients.

show abstract

“…The prevalence of GO in euthyroid and primarily hypothyroid patients ranges between 1.6% and 8.6% [1]. Orbitopathy in hypothyroid/euthyroid patients present with less soft tissue involvement, more asymmetrical disease and clinically less marked symptoms than in primarily hyperthyroid patients [1].…”

Section: Introductionmentioning

confidence: 99%

Rituximab therapy in steroid resistant thyroid associated ophthalmopathy

Devarbhavi¹,

Maiti²,

Sinha³

et al. 2017

Case Rep Int

View full text Add to dashboard Cite

Introduction:Thyroid associated ophthalmopathy (TAO) is the most frequent extrathyroidal manifestation of Graves' disease. Considerable number of TAO is also found with euthyroid or hypothyroid state and responds to present mainstay of therapy i.e corticosteroid. However, some patients with TAO are resistant to steroid therapy and may progress to vision threatening orbitopathy. Radiotherapy, surgical decompression and cyclosporine in combination with oral or intravenous glucocorticoid were the other options in such cases. But recently rituximab a monoclonal anti CD20 antibody which was successfully used in other

show abstract

Euthyroid and primarily hypothyroid patients develop milder and significantly more asymmetrical Graves ophthalmopathy

Cited by 120 publications

References 22 publications

Hyperthyroid vs hypothyroid eye disease: the same severity and activity

Hyperthyroid vs hypothyroid eye disease: the same severity and activity

Clinical features of thyroid-associated ophthalmopathy in clinically euthyroid Korean patients

Rituximab therapy in steroid resistant thyroid associated ophthalmopathy

Contact Info

Product

Resources

About