Endocrine Abstracts

Introduction: Graves’ orbitopathy (GO), represents the main extrathyroid manifestation of Graves’ disease, with a wide variety of clinical presentations. According to Rundle’s curve, GO is characterized by an Initial phase inflammatory phase, a severity peak followed by a stable plateau phase (fibrotic phase).

Objectives: To identify and describe GO patterns distinct from the Rundle’s curve.

Methods/Case Presentation: Five hundredn and sixty six patients with GD were included in the study, with 197 patients developing GO during the 60 months follow-up as determined by the clinical activity score (CAS) and evaluated every six months over 60 months. Serum TSH, FT4 and thyroid stimulating hormone receptor antibody (TRAb) positivity were also determined. The relationship between the patterns identified and the two main treatment alternatives was also evaluated. Group 1 (n = 115) consisted of patients that followed the Rundles’ Curve pattern and group 2 (n = 82) consisted of patients with GO evolution characterized by periods of worsening and improvement of inflammatory signs of GO.

Results: In Group R, mean age and standard deviation (SD) was 39 ± 10 years, and 75% of patients were female, mean initial TSH was 0.018 ± 0.03 uUI/ml, mean initial FT4 was 4.46 ± 2.10 ng/dL, 85% were TRAb-positive, and 48% smoked. In Group NR, mean age was 40 ± 11 years, and 80% of patients were female, mean initial TSH was 0.018 ± 0.03 uUI/ml, mean initial FT4 was 3.87 ± 1.81 ng/dL 84% were TRAb positive, and 38% were smokers.

Conclusion: This study described a group of patients with GO evolution different than Rundle’s curve characterized by periods of worsening and improvement of inflammatory signs of GO, suggesting that GO is a recurrent chronic disease.