Endocrine Abstracts (2019) 65 P404 | DOI: 10.1530/endoabs.65.P404

Thyroid eye disease (TED): patient demographics across three multi-disciplinary (MDT) clinics in London, UK

Soma Farag1, Claire Feeney1, Vickie Lee1, Sonali Nagendran2, Ahmad Aziz1, Vassiliki Bravis3, Rajni Jain1, Rashmi Akshikar1, Karim Meeran4 & Stephen Robinson3


1Western Eye Hospital, London, UK; 2Central Middlesex Hospital, London, UK; 3St Mary’s Hospital, London, UK; 4Charing Cross Hospital, London, UK


Purpose: There is increasing evidence that a multidisciplinary (MDT) approach optimises diagnosis and management in active Thyroid Eye Disease (TED) and is recommended by current TEAMeD-5 guidelines1. Here we aim to describe the clinical and endocrine characteristics of a large cohorts of patients with TED seen in 3 MDT clinics in London.

Methods: A retrospective patient-cohort study of 236 patients with suspected TED referred to these services between 2012 and 2019. Whole group correlations and subgroup analyses were analysed at baseline across several patient factors.

Results: Median patient age was 49.0 years, 77.5% were female, 23.3% Afro-Caribbean. 166 (70.3%) were on treatment for Graves’ thyrotoxicosis, 25(10.6%) were hypothyroid at first clinic and 29 (12.3%) had normal thyroid function and on no treatment. Of 183 (77.5%) patient who had an autoantibody measurement, 80.5% had positive thyroid-stimulating hormone (TSH) antibody titre, with the median titre being 6.6 IU/l (IQR:2.4–17.8, normal: <1.75 IU/l). A positive correlation between Clinical Activity Score (CAS) and TSH antibody titre was found (R = 0.30, P <0.05). There were 52/236 (22.0%) current smokers, all of whom received documented smoking cessation advice. 32.5% patients had a positive family history for thyroid disease, however significantly fewer patients with sight-threatening disease had a positive FH than those without (P<0.05). Patients with sight-threatening disease were significantly older than those without (P = 0.0378).

Conclusion: These results suggest that cases of sight-threatening disease were more prevalent in older populations and reported family history was not a predictor of disease activity. TSH R antibody demonstrated a positive correlation CAS but other factors influence the variance seen in CAS. Further biomarkers are warranted in this complex, costly and debilitating disease.