Thyroid-stimulating immunoglobulins indicate the onset of dysthyroid optic neuropathy

Journal of Endocrinological Investigation
K A PontoGeorge Kahaly

Abstract

Recognition of dysthyroid optic neuropathy (DON) requires sensitive diagnostic tools. Clinical assessment may fail to reliably evaluate the acuteness of DON especially if signs for inflammation are missing. Aim of this cross-sectional study was to assess the relationship between thyroid-stimulating immunoglobulins (TSI) and onset of DON. At a multidisciplinary orbital center, serum TSI levels were measured in 180 consecutive patients with thyroid eye disease (TED) and 302 healthy controls with a FDA-cleared cell-based bioassay using a chimeric TSH receptor and a CRE-dependent luciferase. Thirty of 180 (16.7 %) patients with TED had DON of recent onset or a past history of DON (post-DON). Optic disk swelling was present and visual-evoked potentials were pathologic in all eyes with DON of recent onset, but in one of 13 (7.7 %) with post-DON, only (p = 0.005). 19/20 (96 %) patients with DON of recent onset were TSI-positive. TSI was associated with DON of recent onset (OR: 20.96; 95 % CI 1.064-412.85, p = 0.045). All controls were TSI negative. TSI correlated with the clinical activity score (R = 0.70, p < 0.001) and higher TSI-levels were noted in active vs. inactive TED (485.1 ± 132.3 vs. 277.7 ± 143.7 %, cut-off < 140 %; p < 0....Continue Reading

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Citations

May 21, 2016·Journal of Endocrinological Investigation·T DianaG J Kahaly
Mar 12, 2016·Expert Review of Clinical Pharmacology·Marek Ruchała, Nadia Sawicka-Gutaj
Oct 27, 2017·European Thyroid Journal·Tanja DianaGeorge J Kahaly
May 18, 2018·Ophthalmic Plastic and Reconstructive Surgery·Tanja Diana, George J Kahaly
Jun 22, 2018·Ophthalmic Plastic and Reconstructive Surgery·Peerooz SaeedPeter H L T Bisschop
Dec 14, 2019·Journal of Endocrinological Investigation·A C H LeeG J Kahaly
Feb 6, 2020·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·George J KahalyPaul D Olivo
Feb 11, 2020·Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society·Terry J Smith
Feb 13, 2019·The Journal of Clinical Endocrinology and Metabolism·George J KahalyTanja Diana
Aug 5, 2020·Journal of Endocrinological Investigation·T DianaG J Kahaly
Feb 9, 2020·Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft·Katharina A PontoGeorge J Kahaly
Dec 24, 2017·Journal of Molecular Endocrinology·Michelle Mohyi, Terry J Smith
Sep 16, 2020·The Journal of Clinical Endocrinology and Metabolism·George J Kahaly
Oct 14, 2019·Best Practice & Research. Clinical Endocrinology & Metabolism·George J Kahaly, Lara Frommer
Jan 7, 2021·Therapeutic Advances in Endocrinology and Metabolism·Jan LängerichtGeorge J Kahaly
Jul 16, 2021·Therapeutic Advances in Ophthalmology·Clara J MenSara T Wester

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