Endocrine Abstracts

Introduction: The Oxford multidisciplinary thyroid eye disease (TED) clinic comprising an oculoplastic surgeon, rheumatologist and endocrinologist with access to orthoptics, neuroradiology and radiotherapy was established in 2013. The aim of the service is to facilitate rapid referral and treatment in a specialist centre in keeping with the Amsterdam Declaration. Early use of steroid sparing agents (SSA) and recently rituximab form part of the treatment regimen.<...

Introduction: The Oxford multidisciplinary thyroid eye disease (TED) clinic comprising an oculoplastic surgeon, rheumatologist and endocrinologist with access to orthoptics, neuroradiology and radiotherapy was established in 2013. The aim of the service is to facilitate rapid referral and treatment in a specialist centre in keeping with the Amsterdam Declaration. Early use of steroid sparing agents (SSA) and recently rituximab form part of the treatment regimen.<...

Introduction: The Oxford multidisciplinary thyroid eye disease (TED) clinic comprising an oculoplastic surgeon, rheumatologist and endocrinologist with access to orthoptics, neuroradiology and radiotherapy was established in 2013. The aim was to facilitate rapid referral and treatment in a specialist centre in keeping with Amsterdam Declaration. Early use of steroid sparing agents (SSA) and recently rituximab forms part of the treatment regimen.Methods: ...

Introduction: The management of active thyroid eye disease (TED) remains controversial. High dose intravenous methylprednisolone (IVMP) is the current recommended first-line treatment based on EUGOGO guidance. Such therapy has the potential for serious adverse effects. We present the outcomes of an alternative approach in the management of moderate-to-severely active TED, using steroid-sparing agents (SSAs) in conjunction with IVMP. Methotrexate is used as the first-line SSA a...

Background: Thyroid eye disease (TED) is an autoimmune inflammatory disease that can be both disfiguring and potentially sight threatening. Suppression of inflammation in active disease can reduce the risk of visual loss and limit long-term sequelae of the disease. Current disease management involves suppression of inflammation using glucocorticoids. The aim of our study was to evaluate the efficacy of early disease intervention with targeted immunomodulatory therapy to alter ...

Myasthenia gravis (MG) and Graves’ ophthalmopathy (GO) share many clinical characteristics but may also co-exist. Both are autoimmune disorders mediated by organ specific pathogenic autoantibodies to membrane surface receptors. Differential diagnosis and/or co-existence provides a potential management challenge, and there is a paucity of demographic information regarding precise prevalence rates and concurrence of disease.Method: Re...

Purpose: Graves’ disease is an autoimmune condition that can cause hyperthyroidism and thyroid eye disease (TED). Definitive treatment is required in approximately 50% patients. Thyroidectomy remains the least chosen primary treatment (2%-18%) despite it having the highest cure rate (>95%). Our aim was to determine the current relationship between patients’ TED and thyroidectomy in a multidisciplinary specialist eye clinic at a tertiary referral centre.<p cla...

Generally, after an initial active phase TED rarely reactivates. However, epidemiological evidence is scant. The following cases highlight the propensity for Graves’ orbitopathy to reactivate many years later.Case 1: A 69-year-old woman had Graves’ disease aged 29, and was reviewed in the TED clinic (ophthalmology, rheumatology and endocrinology), with reactivation of orbitopathy 40 years after initial disease. She was an ex-smoker, had hyperte...

Background: Thyroid eye disease (TED) is an autoimmune inflammatory disease associated with Graves’ disease. Rituximab (a monoclonal antibody that depletes B-cells), has recently been shown to be effective in treating TED. There is evidence to support an association with increased TRAbs and TED severity, and one study has demonstrated a fall in TRAbs with rituximab therapy. The aim of this study was to assess the clinical efficacy of low dose rituximab in patients with TE...