ECE2015 Guided Posters Thyroid – hyperthyroidism and treatment (8 abstracts)
There is a detectable immune activity in the orbits of all patients diagnosed with Graves' disease regardless of later development of Graves' orbitopathy
Eszter Berta 1, , Bernadett Újhelyi 4 , Lajos Szabados 3 , László Galuska 3 , Annamária Erdei 1 , Annamária Gazdag 1 , Sándor Halmi 1, , Endre Nagy 1 & Miklós Bodor 1,
1Division of Endocrinology, Department of Medicine, University of Debrecen, Debrecen, Hungary; 2Department of Clinical Pharmacology, University of Debrecen, Debrecen, Hungary; 3Department of Nuclear Medicine, University of Debrecen, Debrecen, Hungary; 4Department of Ophthalmology, University of Debrecen, Debrecen, Hungary.
Graves’ orbitopathy (GO) is a common complication of Graves’ disease (GD) which is often responding poorly to therapy. GO may develop before or together with, or during the course of GD. In an individual patient, the development of GO cannot be predicted. We assumed that orbital autoimmune activity is predictable using orbital 99mTc-labelled diethylenetriamine pentaacetic acid (99mTc-DTPA) SPECT. We aimed to determine whether any orbital autoimmune activity can be identified in patients who do not develop GO during their follow-up. Fifty-four orbits of 27 patients newly diagnosed with GD were entered into the study. Patients with present GO were excluded. None of the patients had received antithyroid drugs or ophthalmic measures before entering the study. An initial 99mTc-DTPA SPECT was performed and DTPA uptake as sign of disease activity calculated in each case. SPECT was repeated during follow-up if clinical signs of GO occurred, and a final SPECT was performed at the end of the follow-up period, after 1 year. Twenty orbits of control patients who underwent DTPA SPECT of the hands for Raynaud’s phenomenon served as controls. During the 2-year follow-up, six out of the 27 patients (22%) were diagnosed with newly developed GO. The mean initial DTPA uptake of the orbits of GD patients with or without later developing GO was significantly higher than results obtained from the control group (10.45±1.72, 9.18±1.18, and 7.7±2.44 MBq/cm3, respectively, P<0.05). Initial DTPA uptake values of the six patients who later developed GO were not different from the rest of the GD group. All GD patients have mild orbital activity signs by the DTPA technique in the early stage of GD, irrespective of development or lack of GO during the course of GD. This uniform ongoing subclinical inflammation may be a reversible early stage of GO.
Volume 37
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Endocrine Abstracts
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