April - June 2009, Volume 5, Issue 2

Cozma I, Cozma LS, Boyce RL, Ludgate ME, Lazarus JH, Lane CM

Variation in thyroid status in patients with Graves' orbitopathy

Acta Endo (Buc) 2009, 5 (2): 191-198
doi: 10.4183/aeb.2009.191

Graves’ orbitopathy usually occurs in thyrotoxic patients at the presentation of the\r\nhyperthyroidism.\r\nAim: we conducted a cross sectional study over 8 and a half years of the relation\r\nbetween Graves’ orbitopathy and thyroid status in patients presenting to our joint thyroidophthalmology\r\nclinic at University Hospital of Wales.\r\nMethods: Patients with active orbitopathy were diagnosed clinically and with\r\nappropriate imaging where necessary. This series excluded patients previously treated with\r\nradioiodine or surgery for Graves’ disease. Of 259 patients 140 (54%) had not had 131I or\r\nsurgical therapy. Thirty four percent of the 140 had never been hyperthyroid of whom 19\r\n(13.5%) were euthyroid. Twenty nine of the 140 (20.7%) were hypothyroid receiving\r\nlevothyroxine at referral. There were no significant differences between the hyperthyroid\r\nand non hyperthyroid groups in the incidence of cigarette smoking, family history of thyroid\r\ndisease or maximum proptosis at presentation.\r\nResults: We found a higher prevalence of smokers than reported in the literature in\r\nmoderate and severe TAO across all thyroid status groups including hypothyroid only\r\npatients. This study has emphasized the occurrence of Graves’ orbitopathy in hypothyroid\r\npatients as well as euthyroid individuals.

Keywords: Orbitopathy, Graves’ disease, Hypothyroidism, Smoker

Correspondence: JH Lazarus, Centre for Endocrine and Diabetes Sciences, University Hospital of\r\nWales, Heath Park, Cardiff CF14 4XN, Wales, UK, Tel +44-2920744326 Fax: +44-2920744326\r\nE mail: Lazarus@cf.ac.uk