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Pediatric Graves' ophthalmopathy: The pre- and postpubertal experience

Lookup NU author(s): Dr Henry Holt

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Abstract

Purpose: Graves' disease is rare in children. The associated orbitopathy has not been well-characterized. In particular, the unique features of prepubertal Graves' orbitopathy are poorly described. In this study, we compare pre- and postpubertal Graves' orbitopathy and contrast our findings with those reported previously. Methods: A retrospective chart review identified children with Graves' disease diagnosed clinically and serologically and treated at Children's Hospital Boston between 1996 and 2006. Pre- and postpubertal patients were segregated with the use of Tanner staging. Ophthalmic findings (including eyelid findings, proptosis, and strabismus) in the two groups were compared. Results: Of the 163 patients identified, 85 (52%) had some ocular signs referable to Graves' disease. Girls outnumbered boys by 7:1. Ophthalmologic consultation was obtained on only 27 patients (16%). In the prepubertal group (n = 6), 83% had lid retraction or lid lag, 50% had proptosis, and none had clinically apparent strabismus, chemosis, or preorbital fat pad enlargement. In the postpubertal group (n = 21), 86% had lid lag or lid retraction, 80% had proptosis, 5% had chemosis, 33% had preorbital fat pad enlargement, and 24% had restrictive strabismus. Conclusions: Although the reported incidence of Graves' orbitopathy is 37%-67%, ophthalmology consultations were obtained on only 16% of patients treated at our institution (27 patients during a 10-year period.) Although prepubertal patients appeared to have less severe Graves' orbitopathy and absence of restrictive strabismus, the number of subjects was too small for meaningful statistical analysis.{A figure is presented}. © 2008 American Association for Pediatric Ophthalmology and Strabismus.

Publication metadata

Author(s): Holt H, Hunter DG, Smith J, Dagi LR

Publication type: Article

Publication status: Published

Journal: Journal of AAPOS

Year: 2008

Volume: 12

Issue: 4

Pages: 357-360

Print publication date: 01/08/2008

ISSN (print): 1091-8531

ISSN (electronic): 1528-3933

Publisher: Mosby, Inc.

URL: http://dx.doi.org/10.1016/j.jaapos.2007.12.011

DOI: 10.1016/j.jaapos.2007.12.011

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