Document Detail


Prevalence and Natural History of Graves' Orbitopathy in a Large Series of Patients with Newly Diagnosed Graves' Hyperthyroidism Seen at a Single Center.
MedLine Citation:
PMID:  23408569     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background:The prevalence and natural history of Graves' orbitopathy (GO) are poorly documented.Methods:A large series of 346 patients with newly diagnosed and recent onset Graves' hyperthyroidism seen at a single (nontertiary referral) center over an 8-year period were enrolled in an observational prospective study and evaluated for GO activity and severity according to the EUGOGO (European Group on Graves' Orbitopathy) criteria. After excluding patients immediately treated for moderate-to-severe GO, patients undergoing total thyroidectomy or radioactive iodine treatment, and patients lost to follow-up, 237 patients were submitted to antithyroid drug (ATD) treatment, with ocular evaluation at 6, 12, and 18 months.Results:Among the whole cohort, at presentation 255 (73.7%) had no ocular involvement, 70 (20.2%) had mild and inactive GO, 20 (5.8%) had moderate-to-severe and active GO, and 1 (0.3%) had sight-threatening GO with dysthyroid optic neuropathy. Of the 237 patients who completed the 18-month follow-up during or after ATD treatment, 194 (81.9%) had no GO at baseline. Progression to moderate-to-severe GO occurred in 5 (2.6%) of these patients. Of the 43 (18.1%) patients with mild and inactive GO at baseline, 1 (2.4%) progressed to moderate-to-severe GO, and 25 (58.1%) experienced complete remission.Conclusions:Most patients with newly diagnosed Graves' disease have no ocular involvement. Moderate-to-severe and active GO or sight-threatening GO are rare at presentation and rarely develop during ATD treatment. Most patients (>80%) with no GO at baseline do not develop GO after an 18-month follow-up period. Remission of mild GO occurs in the majority of cases.
Authors:
M L Tanda; E Piantanida; L Liparulo; G Veronesi; A Lai; L Sassi; N Pariani; D Gallo; C Azzolini; M Ferrario; L Bartalena
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-13
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  -     ISSN:  1945-7197     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Section of Endocrinology (M.L.T., E.P., L.L., A.L., L.S., N.P., D.G., L.B.) and Research Center in Epidemiology and Preventive Medicine (EPIMED) (G.V., M.F.), Department of Clinical and Experimental Medicine; and Department of Surgical and Morphological Sciences (C.A.), University of Insubria, 21100 Varese, Italy.
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