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Published in: Journal of Endocrinological Investigation 3/2017

01-03-2017 | Short Review

Natural course of mild Graves’ orbitopathy: is it a chronic remitting or a transient disease?

Authors: P. Anagnostis, K. Boboridis, F. Adamidou, M. Kita

Published in: Journal of Endocrinological Investigation | Issue 3/2017

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Abstract

Background/Aims

The natural course of Graves’ orbitopathy (GO) has been poorly documented. The aim of this review is to provide current knowledge regarding the natural course of mild GO, trying to address the issue of whether and to what extent it constitutes a chronic remitting or transient disease.

Methods

We systematically searched PubMed for English language publications until August 2016 under the following terms: “Graves’ orbitopathy” OR “Graves’ ophthalmopathy” OR “thyroid eye disease” AND “natural course” OR “natural history”.

Results

Few studies have investigated the course of mild orbital disease in patients with GO. Large controlled trials are lacking and data can be extracted mainly from small retrospective and some prospective studies, after excluding patients who had received radioiodine for thyrotoxicosis or surgical treatment for GO. In general, more than half of GO patients may show spontaneous improvement in their clinical features, whereas no safe conclusions can be drawn with regard to complete resolution, with percentages ranging from 6 to 58 %.

Conclusions

The question whether mild GO is a remitting, albeit chronic disease, or even a transient event in the course of Graves’ disease, remains currently unanswered.
Literature
1.
go back to reference Bartalena L, Fatourechi V (2014) Extrathyroidal manifestations of Graves’ disease: a 2014 update. J Endocrinol Invest 37:691–700CrossRefPubMed Bartalena L, Fatourechi V (2014) Extrathyroidal manifestations of Graves’ disease: a 2014 update. J Endocrinol Invest 37:691–700CrossRefPubMed
3.
go back to reference Terwee C, Wakelkamp I, Tan S, Dekker F, Prummel MF, Wiersinga W (2002) Long-term effects of Graves’ ophthalmopathy on health-related quality of life. Eur J Endocrinol 146:751–757CrossRefPubMed Terwee C, Wakelkamp I, Tan S, Dekker F, Prummel MF, Wiersinga W (2002) Long-term effects of Graves’ ophthalmopathy on health-related quality of life. Eur J Endocrinol 146:751–757CrossRefPubMed
4.
go back to reference Bartley GB, Fatourechi V, Kadrmas EF, Jacobsen SJ, Ilstrup DM, Garrity JA, Gorman CA (1996) Long-term follow-up of Graves ophthalmopathy in an incidence cohort. Ophthalmology 103:958–962CrossRefPubMed Bartley GB, Fatourechi V, Kadrmas EF, Jacobsen SJ, Ilstrup DM, Garrity JA, Gorman CA (1996) Long-term follow-up of Graves ophthalmopathy in an incidence cohort. Ophthalmology 103:958–962CrossRefPubMed
5.
go back to reference Bartalena L, Baldeschi L, Boboridis K, Eckstein A, Kahaly GJ, Marcocci C, Perros P, Salvi M, Wiersinga WM, European Group on Graves’ Orbitopathy (EUGOGO) (2016) The 2016 European Thyroid Association/European Group on Graves’ Orbitopathy Guidelines for the Management of Graves’ Orbitopathy. Eur Thyroid J 5:9–26CrossRefPubMedPubMedCentral Bartalena L, Baldeschi L, Boboridis K, Eckstein A, Kahaly GJ, Marcocci C, Perros P, Salvi M, Wiersinga WM, European Group on Graves’ Orbitopathy (EUGOGO) (2016) The 2016 European Thyroid Association/European Group on Graves’ Orbitopathy Guidelines for the Management of Graves’ Orbitopathy. Eur Thyroid J 5:9–26CrossRefPubMedPubMedCentral
6.
go back to reference Rundle FF (1957) Management of exophthalmos and related ocular changes in Graves’ disease. Metabolism 6:36–47PubMed Rundle FF (1957) Management of exophthalmos and related ocular changes in Graves’ disease. Metabolism 6:36–47PubMed
7.
go back to reference Marcocci C, Bruno-Bossio G, Manetti L, Tanda ML, Miccoli P, Iacconi P, Bartolomei MP, Nardi M, Pinchera A, Bartalena L (1999) The course of Graves’ ophthalmopathy is not influenced by near total thyroidectomy: a case-control study. Clin Endocrinol (Oxf) 51:503–508CrossRef Marcocci C, Bruno-Bossio G, Manetti L, Tanda ML, Miccoli P, Iacconi P, Bartolomei MP, Nardi M, Pinchera A, Bartalena L (1999) The course of Graves’ ophthalmopathy is not influenced by near total thyroidectomy: a case-control study. Clin Endocrinol (Oxf) 51:503–508CrossRef
8.
go back to reference Tallstedt L, Lundell G, Tørring O, Wallin G, Ljunggren JG, Blomgren H, Taube A, The Thyroid Study Group (1992) Occurrence of ophthalmopathy after treatment for Graves’ hyperthyroidism. N Engl J Med 326:1733–1738CrossRefPubMed Tallstedt L, Lundell G, Tørring O, Wallin G, Ljunggren JG, Blomgren H, Taube A, The Thyroid Study Group (1992) Occurrence of ophthalmopathy after treatment for Graves’ hyperthyroidism. N Engl J Med 326:1733–1738CrossRefPubMed
9.
go back to reference Bartalena L, Macchia PE, Marcocci C, Salvi M, Vermiglio F (2015) Effects of treatment modalities for Graves’ hyperthyroidism on Graves’ orbitopathy: a 2015 Italian Society of Endocrinology Consensus Statement. J Endocrinol Invest 38:481–487CrossRefPubMedPubMedCentral Bartalena L, Macchia PE, Marcocci C, Salvi M, Vermiglio F (2015) Effects of treatment modalities for Graves’ hyperthyroidism on Graves’ orbitopathy: a 2015 Italian Society of Endocrinology Consensus Statement. J Endocrinol Invest 38:481–487CrossRefPubMedPubMedCentral
10.
go back to reference Selva D, Chen C, King G (2004) Late reactivation of thyroid orbitopathy. Clin Exp Ophthalmol 32:46–50CrossRefPubMed Selva D, Chen C, King G (2004) Late reactivation of thyroid orbitopathy. Clin Exp Ophthalmol 32:46–50CrossRefPubMed
11.
go back to reference Werner SC (1969) Classification of the eye changes of Graves’ disease. J Clin Endocrinol Metab 29:982–984CrossRefPubMed Werner SC (1969) Classification of the eye changes of Graves’ disease. J Clin Endocrinol Metab 29:982–984CrossRefPubMed
14.
go back to reference Noth D, Gebauer M, Müller B, Bürgi U, Diem P (2001) Graves’ ophthalmopathy: natural history and treatment outcomes. Swiss Med Wkly 131:603–609PubMed Noth D, Gebauer M, Müller B, Bürgi U, Diem P (2001) Graves’ ophthalmopathy: natural history and treatment outcomes. Swiss Med Wkly 131:603–609PubMed
15.
go back to reference Menconi F, Profilo MA, Leo M, Sisti E, Altea MA, Rocchi R, Latrofa F, Nardi M, Vitti P, Marcocci C, Marinò M (2014) Spontaneous improvement of untreated mild Graves’ ophthalmopathy: Rundle’s curve revisited. Thyroid 24:60–66CrossRefPubMedPubMedCentral Menconi F, Profilo MA, Leo M, Sisti E, Altea MA, Rocchi R, Latrofa F, Nardi M, Vitti P, Marcocci C, Marinò M (2014) Spontaneous improvement of untreated mild Graves’ ophthalmopathy: Rundle’s curve revisited. Thyroid 24:60–66CrossRefPubMedPubMedCentral
16.
go back to reference Streeten DH, Anderson GH Jr, Reed GF, Woo P (1987) Prevalence, natural history and surgical treatment of exophthalmos. Clin Endocrinol (Oxf) 27:125–133CrossRef Streeten DH, Anderson GH Jr, Reed GF, Woo P (1987) Prevalence, natural history and surgical treatment of exophthalmos. Clin Endocrinol (Oxf) 27:125–133CrossRef
17.
go back to reference Perros P, Crombie AL, Kendall-Taylor P (1995) Natural history of thyroid associated ophthalmopathy. Clin Endocrinol (Oxf) 42:45–50CrossRef Perros P, Crombie AL, Kendall-Taylor P (1995) Natural history of thyroid associated ophthalmopathy. Clin Endocrinol (Oxf) 42:45–50CrossRef
18.
go back to reference Tanda ML, Piantanida E, Liparulo L, Veronesi G, Lai A, Sassi L, Pariani N, Gallo D, Azzolini C, Ferrario M, Bartalena L (2013) Prevalence and natural history of Graves’ orbitopathy in a large series of patients with newly diagnosed graves’ hyperthyroidism seen at a single center. J Clin Endocrinol Metab 98:1443–1449CrossRefPubMed Tanda ML, Piantanida E, Liparulo L, Veronesi G, Lai A, Sassi L, Pariani N, Gallo D, Azzolini C, Ferrario M, Bartalena L (2013) Prevalence and natural history of Graves’ orbitopathy in a large series of patients with newly diagnosed graves’ hyperthyroidism seen at a single center. J Clin Endocrinol Metab 98:1443–1449CrossRefPubMed
19.
go back to reference Marcocci C, Kahaly GJ, Krassas GE, Bartalena L, Prummel M, Stahl M, European Group on Graves’ Orbitopathy et al (2011) Selenium and the course of mild Graves’ orbitopathy. N Engl J Med 364:1920–1931CrossRefPubMed Marcocci C, Kahaly GJ, Krassas GE, Bartalena L, Prummel M, Stahl M, European Group on Graves’ Orbitopathy et al (2011) Selenium and the course of mild Graves’ orbitopathy. N Engl J Med 364:1920–1931CrossRefPubMed
Metadata
Title
Natural course of mild Graves’ orbitopathy: is it a chronic remitting or a transient disease?
Authors
P. Anagnostis
K. Boboridis
F. Adamidou
M. Kita
Publication date
01-03-2017
Publisher
Springer International Publishing
Published in
Journal of Endocrinological Investigation / Issue 3/2017
Electronic ISSN: 1720-8386
DOI
https://doi.org/10.1007/s40618-016-0555-0

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