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Thyroid eye disease (TED), also known as Graves’ orbitopathy is an autoimmune condition that affects the eye tissue. The most common cause TED is Graves’ disease. 20% of cases occur six months prior to diagnosis. Hyperthyroidism is present in 40% of cases prior to and after diagnosis.
Signs and Symptoms:
Some patients diagnosed with TED may not have any symptoms, but at least half report symptoms:
...
It’s the buzz word of the year: self-care.
You’ve probably seen the articles about why self-care isn’t selfish and the lists of activities you can do to look after yourself. The stories invoke images of massages and spa days, sipping vibrant veggie juices in trendy yoga outfits and snugging up with a blanket and a book in front of the fireplace.
But when your energy and mobility are limited, self-care becomes a lot less g...
Hyperthyroidism (also known as an overactive thyroid) occurs when the thyroid gland makes too much thyroid hormone (thyroxine). Hyperthyroidism is relatively rare in childhood, occurring in about 1 in 5,000 children and adolescents. With the right diagnosis and management, hyperthyroidism is a treatable disease, and your child can go on to live a full, active, and enjoyable life. There are several possible causes of hyperthyroidism. Graves dis...
Hyperthyroidism happens when a child’s thyroid gland makes more thyroid hormone than they need. The thyroid gland is butterfly-shaped and is located in the neck, just below Adam’s apple. Its job is to release thyroid hormone into the blood to control the body’s heart rate, temperature, and metabolism. An overactive thyroid gland can get big and it may look and feel like a lump in the throat, especially when the child swallows.
When the...
What is Graves’ disease in children?
Graves’ disease is an autoimmune disease. The immune system normally protects the body from germs with proteins called antibodies. But with an autoimmune disease, the body makes antibodies that attack its own tissues. With Graves’ disease, antibodies cause the thyroid gland to make too much thyroid hormone. This is known as hyperthyroidism. Excess thyroid hormone in the bloodst...
As you grow up it’s only natural to want to feel ‘normal’ and just to fit in with your friends. It can therefore be hard to accept that you have a medical condition that can mean you have to take daily medication. It is understandable that you may feel frustrated to have to miss school or work to attend regular doctors’ appointments, have blood tests, etc. In addition to this, there will be times when you may find it difficult to manag...
Graves ophthalmopathy (GO), which occurs in autoimmune thyroid disease, can reduce patients’ quality of life due to its impact on visual function, physical appearance, and emotional health. Corticosteroids have been the first-line treatment for GO. More recently, the pathogenesis of GO has made significant progress. Various targeting biological agents and immunosuppressive agents make GO management more promising. Fully understanding GO pathog...
The Journal of Clinical Endocrinology & Metabolism
Year: 2022
Health-related quality of life (HQOL) is a concept that aims to understand the totality of an individual’s experience of their disease state. This can include the physical, psychosocial, emotional, and psychological effects of a disease state. A complex and multifactorial concept, HQOL can be challenging to measure accurately and reliably. Thyroid eye disease (TED), as a multifaceted physically debilitating and facial disfiguring disorder, pre...
The Journal of Clinical Endocrinology & Metabolism
Year: 2022
Context: Thyroid eye disease (TED) is a sight-threatening and debilitating autoimmune condition, with limited therapies available, that often poses diagnostic and therapeutic challenges. In recent years, the treatment landscape has shifted to early intervention with targeted therapy.
Methods: A PubMed review of the literature was conducted for the period between 19...
The Journal of Clinical Endocrinology & Metabolism
Year: 2022
Background and aims: This review aims to summarize current and emerging therapies for treatment of thyroid eye disease (TED), in the light of novel understanding of pathogenetic mechanisms, leading to new treatment options and clinical trials.
Methods: We reviewed and analyzed peer-reviewed literature reporting recent translational studies and clinical trials in th...
The Journal of Clinical Endocrinology & Metabolism
Year: 2023
Context: Thyroid eye disease (TED), a vision-threatening and disfiguring autoimmune process, has thwarted our efforts to understand its pathogenesis and develop effective and safe treatments. Recent scientific advances have facilitated improved treatment options.
Objective: Review historically remote and recent advances in understanding TED....
Purpose : Teprotumumab was approved as a treatment for thyroid eye disease (TED) in 2020, but some clinicians question whether its high cost is worth its benefits. Cost-effectiveness analyses (CEAs) can help answer this question, but the health utility scores required are rare in TED. In this study we compare costs of teprotumumab with other treatments and use the validated Graves’ orbitopathy quality-of-life (GO-QoL) scor...
Thyroid eye disease (TED) remains challenging for clinicians to evaluate and manage. Novel therapies have recently emerged, and their specific roles are still being determined. Most patients with TED develop eye manifestations while being treated for hyperthyroidism and under the care of endocrinologists. Endocrinologists, therefore, have a key role in diagnosis, initial management, and selection of patients who require referral to specialist...
Thyroid eye disease (TED) remains challenging for clinicians to evaluate and manage. Novel therapies have recently emerged, and their specific roles are still being determined. Most patients with TED develop eye manifestations while being treated for hyperthyroidism and under the care of endocrinologists. Endocrinologists, therefore, have a key role in diagnosis, initial management, and selection of patients who require referral to specialist...
Journal of Endocrinological Investigation
Year: 2015
Graves’ disease is the most frequent form of hyperthyroidism in iodine sufficient countries, and Graves’ orbitopathy (GO) is its most important and common extrathyroidal manifestation, affecting about 25 % of patients. Although GO is generally mild and rarely progressive, thyroid dysfunction, both hyperthyroidism, and hypothyroidism, can influence its course. GO has been reported to improve after correction of hyperthyroidism with antithyr...
Graves’ orbitopathy (GO) is the main extrathyroidal manifestation of Graves’ disease, though severe forms are rare. Management of GO is often suboptimal, largely because available treatments do not target pathogenic mechanisms of the disease. Treatment should rely on a thorough assessment of the activity and severity of GO and its impact on the patient’s quality of life. Local measures (artificial tears, ointments and dark glasses) and control...
Arquivos Brasileiros de Endocrinologia e Metabologia
Year: 2013
Introduction:
Hyperthyroidism is characterized by increased synthesis and release of thyroid hormones by the thyroid gland. Thyrotoxicosis refers to the clinical syndrome resulting from excessive circulating thyroid hormones, secondary to hyperthyroidism or due to other causes. This article describes evidence-based guidelines for the clinical management of thyrotoxicosis.
Objective:
This...
Graves’ disease (GD) is a systemic autoimmune disorder characterized by the infiltration of thyroid antigen-specific T cells into thyroid-stimulating hormone receptor (TSH-R)-expressing tissues. Stimulatory autoantibodies (Ab) in GD activate the TSH-R leading to thyroid hyperplasia and unregulated thyroid hormone production and secretion. Diagnosis of GD is straightforward in a patient with biochemically confirmed thyrotoxicosis, positive TSH-...
Background:
Radioactive iodine (RAI) therapy is the most common method of treating Graves’ disease (GD) in the United States. The current practice is to reevaluate these patients 2-3 months after RAI. The majority are hypothyroid by that time with some experiencing related troublesome symptoms and possible development or worsening of Graves’ orbitopathy. We initiated this randomized controlled trial (RCT) to d...
The diagnosis of Graves’ disease (GD) is traditionally based on the clinical features of persisting hyperthyroidism, enlarged thyroid gland, and often the presence of ophthalmopathy. However, when the clinical presentation of thyrotoxicosis is not diagnostic of GD, the 2011 American Thyroid Association guideline recommends “a radioactive iodine uptake scan should be performed”. Although it is long recognized that Thyrotropin (TSH) recept...
There are three effective treatments for Graves Disease (GD): thyroidectomy, radioactive iodine, and antithyroid drugs. These options differ in their efficacy, safety, convenience, and costs; none is clearly superior to the others for all patients. Practice patterns, however, suggest that patients are more likely to receive a particular mode of therapy depending on where they receive care. This inconsistency of practice suggests that GD patien...
Introduction:
It is possible that the higher cardiovascular risk in Graves’ disease (GD) may be due not only to hemodynamic changes induced by the hyperthyroid state, but also to alterations in the cardiovascular risk factor profile.
Aim:
The aim of our study is to evaluate the association between thyroid function in GD and lipoprotein profile, homocysteine, folate, vitamin B12, high-se...
Introduction:
The cardiovascular system function is modulated by thyroid hormone levels. The antibodies involved in Graves’ disease are central to the pathophysiological consequences of the disease but the impact of their evolution over time is still an area of interest.
Aim:
To evaluate the relationship between thyroid function, autoimmunity, insulin resistance and cardiovascular risk...
Graves’ orbitopathy (GO) is the most common extrathyroidal manifestation of Graves’ disease (GD). According to Rundle’s curve, GO is characterized by an initial phase of increasing activity (inflammatory phase), a severity peak, and a stable plateau phase (fibrotic phase). This overview has an implication in GO therapeutics. Different patterns that are still distinct from Rundle’s curve have not yet been described.
There were 5...
Thyrotoxic crisis better known as thyroid storm is a rare life-threatening endocrine emergency that is the result of dysregulated hypermetabolic state caused by excessive production and release of thyroid hormones compromising multiple organ systems. Unfortunately, this condition carries significant mortality depending on whether the thyroid storm was associated with thyrotoxicosis. Early recognition and treatment are paramount to survival. He...
A healthy 52-year-old woman has had persistent palpitations recently. Serum TSH is < 0.02 mIU/mL (reference, 0.3-4.7 mIU/mL), free T4 is 5.70 ng/dL (reference, 0.8-1.7 ng/dL), and free triiodothyronine (T3) is 1920 pg/dL (reference, 222-383 pg/nL). She has fine bilateral hand tremors and sinus tachycardia. How do we work up this new diagnosis of thyrotoxicosis?
This is one of the most common consults we receive. Thyroid antibodies m...
The purpose of the current study is to confirm safety/tolerability and key pharmacodynamic (PD) effects that are considered to drive clinical benefit in GO patients.
Primary Outcome Measure:
• Assessment of safety by analysis of adverse events (AEs) data [ Time Frame: 7 Weeks ] AE summaries of the number and percent of participants reporting each event at least once will be generated. Other saf...
Brief Summary:
This study is being done to investigate the effects (good and bad) of Rituximab for the treatment of an autoimmune eye disease called Graves’ ophthalmopathy. This disease has proven to be difficult to treat. Rituximab is a monoclonal antibody that depletes a line of cells involved in the autoimmune response. The study hypotheses is that rituximab is effective in the treatment of patients with moderate to...
Graves’ disease is the most common cause of hyperthyroidism (overactive thyroid). It usually affects people between 30-60 years of age and is much more common in women than men. Patients with Graves’ disease, often have enlarged thyroids (goiter) and bulging eyes (exophthalmos). There are three main options to treat Graves’ disease: antithyroid drugs (ATDs), radioactive iodine therapy and surgery.
The most common ATDs in use are...
Early Symptoms
TED can first present with signs or symptoms such as sensitivity to light, a feeling of grittiness in the eyes, excessive tearing, eye pain, or dry eyes. However, these symptoms are often confused with other conditions, such as allergies or dry eye symptoms. Evidence shows that even these first, seemingly mild symptoms can negatively affect patient quality of life. Overlooking them can lead to unnecessary...
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If you are a doctor or other qualified health care professional, you should not offer any medical advice or treatment on our Sites, nor should you allow the content of our Sites to substitute for your own medical judgment. Please thoroughly review the information provided on our Sites before deciding whether any of the products, services, or treatments therein are right for you or others.
The symptoms and treatments for Graves' disease and thyroid eye disease vary, depending on which conditions a patient has been diagnosed with. Select which type you want to learn more about, and oneGRAVESvoice can highlight the resources that are most relevant to you.