The Course of juvenile Graves’ disease in patients with or without clinical features of Graves’ ophthalmopathy

Abstract

Purpose: To compare the course of Graves’ disease (GD) in patients with Graves’ ophthalmopathy (GO) - GO+ group, or without clinical features of GO - GO- group. Method: A total of 130 patients with juvenile Graves’ disease were investigated over the period of 10 years. The median age at GD diagnosis was 18 (12-20) years. GO symptoms occurred in 38 (29.2%) of GD patients.There were evaluated data about the course of the disease: duration of the first course of the treatment, remission time, relapse rate and duration to compare between groups. Results: GO has occurred an average of 1 month from GD diagnosis, minmax values (0-24 months). Ocular symptoms occurred together with GD diagnosis in 84.4 % of GO patients. Analyzing the effectiveness of juvenile GD treatment, we can see that remission from the first attack was achieved within 14,0 months (9.25 to 24,0), of the group of GO- patients, while in patients GO+ group, remission was achieved within 33 (26-40) months of treatment. Relapses in the first 2 years manifested in 60,5% of GO+ group, and in 38,0% of GO- group patients (p = 0,019). The remission longer than one year was observed in 58,7% and 38,0% in GO- and GO+ groups respectively (p = 0,003). Only single attack without relapses of GD occured in 5.3% of GO+ patients group, whereas 40.2% in GO- group (p< 0,001) during the observation period. Conclusion: It was established that a more severe course of Graves’ disease (more frequent relapses, shorter duration of remission, a longer time to achieve euthyrosis) in patients with Graves’ ophthalmopathy compared with patients in the group without clinical signs of ophthalmopathy.The symptoms of Graves´ ophthalmopathy mostly manifest in the beginning of juvenile Graves´ disease.