Endocrine Abstracts

Thyroid-associated ophtalmopathy (TAO) is an organ-specific autoimmune process that is strongly associated with thyroid dysfunction. Patients with TAO may present eyelid retraction, proptosis, chemosis, periorbital oedema and altered ocular motility with significant functional and cosmetic consequences. There is the possibility of coexistence of two or more autoimmune diseases affecting the eye due to the cross-reactivity to common antigens from the eye muscles.

The aim of this study was to evaluate association of TAO with other autoimmune and non-autoimmune diseases and reveal some problems in differential diagnosis of TAO. This study was retrospective and performed on patients diagnosed with TAO in Endocrinology Clinic from Tg-Mures, Romania (January 2000–December 2010). We found 238 patients with TAO with ages between 14 and 75 years, with a peak for women at 40–49 years and 50–59 years for men. Female/male ratio was 4.4/1. 83.19% (meaning 198 patients) were found with hyperthyroidism, 10.09% (24 patients) presented hypothyroidism and 6.72% (16 patients) presented euthyroidism. One hundred and seventy-two patients presented asymmetric exophthalmos and 56 of them – symmetric. One hundred and fifty-eight patients (66.4%) presented associated pathology. We found TAO associated with: multiple sclerosis (2 cases), rheumatoid arthritis (2 cases), psoriasis (2 cases), Marine–Lenhart Syndrome (4 cases), glaucoma (3 cases), ovarian cysts (2 cases), premature ovarian failure (2 cases), systemic lupus erithematosus (4 cases), miastenia gravis (3 cases), vitiligo (6 cases), breast tumor (4 cases), obesity (7 cases), chronic hepatitis (7 cases), diabetes mellitus (8 cases), dysrythmia (18 cases), anaemia (34 cases), hypertension (36 cases).

Also we found TAO after Amiodarone treatment (6 cases), TAO during early pregnancy (8 cases). Patients with TAO might have higher risk of developing another diseases, especially autoimmune diseases and this possibility may be due to immunological cross-reactivity against common autoimmune targets, as well as to a common genetic background.