Endocrine Abstracts

Background and aims: Graves’s disease is associated with specific eye signs that is called as Graves’orbitopathy or ophthalmopathy (GO). GO usually occurs with hyperthyroidism. However it can be sometimes develop several years before the hyperthyroidism. The aim of this presentation is to describe the clinical case of a 48-year-old female patient with euthyroid Graves’ orbitopathy.

Case report: A 48-year old woman presented to the clinic with a few weeks history of exophthalmos. She did not report history of thyroid disease. She was not taking any medication and was not a smoker. Her TSH and FT4 - within normal reference ranges: TSH- 1.1 (n 0.27-4.2 mIU/l), FT4-1.2 (n 0.93-1.7 ng/dl). The level of anti-TSHR was elevated: Anti-TSHR-1.94 (n <1.5 U/l). Ultrasonographically, the volume of the thyroid gland was normal. She was referred to an ophthalmologist. A computed tomography (CT) scan of the orbits showed typical findings of GO. Local therapy measures (artificial tears) and supplementation of selenium was advised for mild case of GO. Currently, the patient is on regular follow-up. She still remains euthyroid.

Conclusion: Graves orbitopathy (GO) usually occurs with hyperthyroidism. However, the patient can sometimes present without thyroid dysfunction in which case it is called euthyroid Graves’ orbitopathy.