Endocrine Abstracts

Background: Thyroid eye disease (TED) affects 25% of patients with Graves’ disease (GD). GD affects nearly 1% of pregnancies. However, data on TED incidence, course, management and outcome in pregnancy are limited.

Aims: To describe the prevalence, course and outcomes of TED in pregnant females.

Methods: A retrospective analysis of electronic health records was conducted in a specialized Joint Thyroid Eye Clinic in Oxford. Individual health records of females in the reproductive age group (18 to 50 years) were screened to identify disease activity and severity of TED during pregnancy and post-partum.

Results: Among 256 patients reviewed in this clinic between 2017 and 2023, 199 were females and 69 were in the reproductive age at the time of first visit. Three patients had TED during pregnancy. All were on pharmacological treatment for thyrotoxicosis throughout pregnancy. TED onset was before pregnancy in all. Two of them remained mild-to-moderate in severity and inactive throughout the pregnancy and puerperium period. One patient required blepharotomy (eyelid lowering) post-partum. One patient developed severely active TED six months post-partum and was successfully managed with rituximab.

Conclusions: The prevalence of TED in pregnancy is rare. In our experience two of three patients remained inactive and mild-to-moderate in severity without the need for specific treatment. It is unclear whether this is due to avoidance of pregnancy with hyperthyroidism/TED or amelioration of autoimmune disease during pregnancy.