Exp Clin Endocrinol Diabetes 2018; 126(10): 628-631
DOI: 10.1055/s-0043-125065
Article
© Georg Thieme Verlag KG Stuttgart · New York

Early Stage Graves’ Disease is Uniformly Accompanied by Orbital Immune Activity even in Patients who Fail to Develop Orbithopathy during Follow-up

Eszter Berta
1   Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
2   Department of Clinical Pharmacology, Faculty of Pharmacy, University of Debrecen, Debrecen, Hungary
,
Miklós Bodor
1   Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
2   Department of Clinical Pharmacology, Faculty of Pharmacy, University of Debrecen, Debrecen, Hungary
,
László Galuska
3   Department of Nuclear Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
,
György Paragh
1   Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
,
Annamária Erdei
1   Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
,
Annamária Gazdag
1   Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
,
Bernadett Ujhelyi
4   Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
,
Ervin Berényi
5   Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
,
Mónika Katkó
1   Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
,
Andrea Gazsó
1   Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
,
Endre V. Nagy
1   Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
› Author Affiliations
Further Information

Publication History

received     01 September 2017
revised      01 December 2017

accepted 18 December 2017

Publication Date:
31 January 2018 (online)

Abstract

Purpose Graves’ orbitopathy (GO) is a complication of Graves’ disease (GD), the development of which cannot be predicted at the time of diagnosis of GD. Our aims were (i) to test if orbital 99mTc-labelled diethylenetriamine pentaacetic acid single-photon emission computer tomography (DTPA SPECT) can predict development of GO later during the course of the disease and (ii) to study whether orbital immune activity can be detected in GD patients who do not develop GO during follow-up.

Methods Fifty-four orbits of 27 patients with newly diagnosed GD were entered into the case-control study. Individuals showing signs of GO at enrolment were excluded. During the two-year follow-up, eye signs were recorded every 3 months. Orbital DTPA uptakes on SPECT images were measured when entering the study and at the end of the follow-up period, or when clinical signs of GO developed, whichever occurred first.

Results During the follow-up, 6 patients (22%) were diagnosed with GO. There was no significant difference between the initial DTPA uptakes of the patients with or without later developing GO (10.45±1.72 MBq/cm3 vs. 9.18±1.18 MBq/cm3 respectively). However, the DTPA uptakes of both GD groups (ie. with and without GO) were higher than that of the control group (7.45±1.36 MBq/cm3, p<0.05).

Conclusions We have shown that GD is accompanied by moderate orbital immune activity in GD patients without GO, irrespective of later development of GO. Why this orbital autoimmunity remains subclinical in the majority of the cases, and progresses into clinically detectable GO in others, remains unclear.