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Prevalence and natural history of Graves' orbitopathy in a large series of patients with newly diagnosed graves' hyperthyroidism seen at a single center.
J Clin Endocrinol Metab. 2013 Apr; 98(4):1443-9.JC

Abstract

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+Show Affiliations

Section of Endocrinology, University of Insubria, Varese, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23408569

Citation

Tanda, M L., et al. "Prevalence and Natural History of Graves' Orbitopathy in a Large Series of Patients With Newly Diagnosed Graves' Hyperthyroidism Seen at a Single Center." The Journal of Clinical Endocrinology and Metabolism, vol. 98, no. 4, 2013, pp. 1443-9.
Tanda ML, Piantanida E, Liparulo L, et al. Prevalence and natural history of Graves' orbitopathy in a large series of patients with newly diagnosed graves' hyperthyroidism seen at a single center. J Clin Endocrinol Metab. 2013;98(4):1443-9.
Tanda, M. L., Piantanida, E., Liparulo, L., Veronesi, G., Lai, A., Sassi, L., Pariani, N., Gallo, D., Azzolini, C., Ferrario, M., & Bartalena, L. (2013). Prevalence and natural history of Graves' orbitopathy in a large series of patients with newly diagnosed graves' hyperthyroidism seen at a single center. The Journal of Clinical Endocrinology and Metabolism, 98(4), 1443-9. https://doi.org/10.1210/jc.2012-3873
Tanda ML, et al. Prevalence and Natural History of Graves' Orbitopathy in a Large Series of Patients With Newly Diagnosed Graves' Hyperthyroidism Seen at a Single Center. J Clin Endocrinol Metab. 2013;98(4):1443-9. PubMed PMID: 23408569.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and natural history of Graves' orbitopathy in a large series of patients with newly diagnosed graves' hyperthyroidism seen at a single center. AU - Tanda,M L, AU - Piantanida,E, AU - Liparulo,L, AU - Veronesi,G, AU - Lai,A, AU - Sassi,L, AU - Pariani,N, AU - Gallo,D, AU - Azzolini,C, AU - Ferrario,M, AU - Bartalena,L, Y1 - 2013/02/13/ PY - 2013/2/15/entrez PY - 2013/2/15/pubmed PY - 2013/6/12/medline SP - 1443 EP - 9 JF - The Journal of clinical endocrinology and metabolism JO - J. Clin. Endocrinol. Metab. VL - 98 IS - 4 N2 - 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. SN - 1945-7197 UR - https://www.unboundmedicine.com/medline/citation/23408569/Prevalence_and_natural_history_of_Graves'_orbitopathy_in_a_large_series_of_patients_with_newly_diagnosed_graves'_hyperthyroidism_seen_at_a_single_center_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2012-3873 DB - PRIME DP - Unbound Medicine ER -