Document Detail


Clinical features of thyroid-associated ophthalmopathy in clinically euthyroid Korean patients.
MedLine Citation:
PMID:  22744391     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 thyroid-stimulating 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%, P<0.001), less active (CAS 1.50 vs 2.26, P=0.014) and less severe clinical course (NOSPECS 3.38 vs 4.13, P=0.037). Lid retraction was more prevalent in group A than group B (91.7% vs 66.2%, P=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, P<0.001). A similar difference was found in the TSI bioassay (201.40% vs 425.19%, P=0.001). The positive rate of TBII in group A (34.8%) was significantly lower than in group B (90.8%, P<0.001). The positive rate of TSI was high in both group A (83.3%) and B (91.7%), with no significant difference (P=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.
Authors:
S Y Jang; S Y Lee; E J Lee; J S Yoon
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-06-29
Journal Detail:
Title:  Eye (London, England)     Volume:  26     ISSN:  1476-5454     ISO Abbreviation:  Eye (Lond)     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-17     Completed Date:  2013-01-17     Revised Date:  2013-09-03    
Medline Journal Info:
Nlm Unique ID:  8703986     Medline TA:  Eye (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  1263-9     Citation Subset:  IM    
Affiliation:
Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Euthyroid Sick Syndromes / diagnosis*,  immunology
Eyelid Diseases / diagnosis,  immunology
Female
Graves Ophthalmopathy / diagnosis*,  immunology
Humans
Hyperthyroidism / diagnosis,  immunology
Immunoglobulins, Thyroid-Stimulating / blood
Korea
Male
Optic Nerve Diseases / diagnosis,  immunology
Receptors, Thyrotropin / immunology
Retrospective Studies
Thyroxine / blood
Tomography, X-Ray Computed
Triiodothyronine / blood
Visual Acuity
Chemical
Reg. No./Substance:
0/Immunoglobulins, Thyroid-Stimulating; 0/Receptors, Thyrotropin; 0/thyrotropin-binding inhibitory immunoglobulin; 6893-02-3/Triiodothyronine; 7488-70-2/Thyroxine
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