Pediatric Thyroid–Associated Orbitopathy: The Children's Hospital of Philadelphia Experience and Literature Review

Goldstein, Scott; Katowitz, William R.; Moshang, Thomas; Katowitz, James A.

doi:10.1089/thy.2008.0014

Cited by 71 publications

(32 citation statements)

References 14 publications

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“…Eyelid retraction (36.1%) and stare (47.2%), lid lag (22.2 %) were the most frequent clinical signs of our studied children. It was similar to other studies [21,22]. The rate of lid retraction and lid lag in our children with thyroid pathology was lower than the rates from 50 to 100% reported by other authors [2,7,13].…”

Section: Clinical Signsupporting

confidence: 92%

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Clinical Ocular Features in Children and Young Adults with Thyroid Diseases

Jankauskienė¹,

Jarušaitienė²

2017

Thyroid Disorders Ther

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The study of clinical ocular manifestations recruited 105 patients who presented to the Endocrine and Eye clinics of Lithuanian University of Medical Sciences with a history of thyroid diseases. The study comprised two groups of patients: the group I included 36 patients (under 18 years) and the group II-69 (from 18 to 34 years). As the control group, 25 children and 30 young adults of similar age without thyroid, eye and systemic diseases were selected.A comprehensive ophthalmic assessment including patient's complaints, best-corrected Snellen visual acuity, ocular motility, proptosis measurements, intraocular pressure (IOP), eyelid signs (lid aperture, lid retraction), slit lamp and fundus investigation was performed.Our investigation confirms that in children with thyroid diseases ocular symptoms and signs such as upper eyelid retraction, stare and mild proptosis were predominant. Young adults with thyroid diseases complained of foreign body sensation, photosensitivity and pain. There was manifestation of eyelid retraction, eyelid oedema and redness, conjunctival redness and chemosis, eyelid retraction, proptosis and widened palpebral fissure. A small number of young adults with thyroid diseases suffered from severe ocular complications as keratopathy, diplopia.This examination may be useful in early diagnosis of ocular changes in children and young adults with thyroid diseases.

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Section: Clinical Signsupporting

confidence: 92%

“…Proptosis in children with thyroid diseases in other studies was from 12 to 100 % [2,7,11,13,21,22] in our study-proptosis was in 25.0% of patients under 18 years old. Eha et al noted that in patients aged 11 years and older, values of proptosis 19 mm were considered as pathological [13].…”

Section: Clinical Signsupporting

confidence: 51%

Clinical Ocular Features in Children and Young Adults with Thyroid Diseases

Jankauskienė¹,

Jarušaitienė²

2017

Thyroid Disorders Ther

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“…Graefe sign (lid lag), eyelid [1,5,6,32]. However, in rare cases myopathy and dysthyroid optic neuropathy (DON) in children and adolescents in course of Graves' disease may also occur [33].…”

Section: Symptoms and Signs Of Thyroidassociated Ophthalmopathymentioning

confidence: 99%

An update on thyroid-associated ophthalmopathy in children and adolescents

Szczapa-Jagustyn¹,

Gotz‐Więckowska²,

Kocięcki³

2016

Journal of Pediatric Endocrinology and Metabolism

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“…Ophtalmopathy observed in children is generally milder compared to adults and is considerably rare below the age of five years. The youngest patient reported in the literature was four months old (11). Ophtalmopathy may be observed as palpebral retraction, palpebral edema, proptosis, chemosis and periorbital edema.…”

Section: Discussionmentioning

confidence: 99%

A case of infantile-onset Graves

Altıncık¹,

Gençpınar²,

Demir³

et al. 2013

Turk Pediatri Ars

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SummaryGraves' disease is an autoimmune disorder presenting with hyperthyroidism and the disease is rare in the childhood. A two-year-old female patient was admitted to our clinic for her evident orbital puffiness. Physical examination revealed propitosis, tachycardia and a hyperpigmented spot with a diameter of 6x4 cm on the skin of the left hemithorax. Thyroid function tests were as follows: fT4: 4,00 ng/dl (N:0,8-1,9), fT3: 7,7 pg/ml (N:1,57-4,71), TSH:0,004 uIU/ml (N:0,4-5), anti-thyroglobulin: <20 IU/mL (N:0-50), anti-thyroid peroxidase: 45,7 IU/mL (N:0-50). To distinguish Graves' disease and Mc Cune Albright syndrome, TSH receptor antibody (TRAb) level and bone survey (X-ray) were evaluated. The TRAb level was 57 IU/L (N:0-9) and there was no finding consistent with fibrous dysplasia on bone X-rays. Propylthiouracil was started with a diagnosis of Graves' disease. In her clinical follow-up, propylthiouracil was switched to methimazole because of a potential risk of hepatotoxicity. TRAb titers remained high and propitosis persisted. There was no evidence of ophthalmopathy on orbital magnetic resonance imaging (MRI). In this report, we described a patient with Graves' disease who presented with proptosis because the disease and its ocular manifestations occur rarer in children compared to adults. Mc-Cune Albright syndrome was also discussed as a differential diagnosis. (Turk Arch Ped 2013; 48: 332-325)

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Pediatric Thyroid–Associated Orbitopathy: The Children's Hospital of Philadelphia Experience and Literature Review

Cited by 71 publications

References 14 publications

Clinical Ocular Features in Children and Young Adults with Thyroid Diseases

Clinical Ocular Features in Children and Young Adults with Thyroid Diseases

An update on thyroid-associated ophthalmopathy in children and adolescents

A case of infantile-onset Graves

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