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J Endocrinol Invest. 1991 Mar;14(3):209-12. Related Articles,

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Identification of a subgroup of Graves' disease patients at higher

risk for severe ophthalmopathy after radioiodine.

Barth A, Probst P, Burgi H.

Department of Medicine, Burgerspital, Solothurn, Switzerland.

We have analyzed retrospectively the records of 89 patients with

Graves' disease who were treated with radioiodine between 1980-88

and whose ophthalmopathy was recorded in a uniform manner initially

and after 5 and 12 months. Moreover information on progression of

eye disease was obtained by telephone for all patients after an

average of 72 months. Pretreatment endocrine ophthalmopathy (class

greater than or equal to 1 of classification of American Thyroid

Association) was present in 34% of the patients. Eight patients

developed proptosis over 20 mm, 7 patients severe ophthalmopathy

(classes 4 to 6), 5 patients required special treatment for eye

disease. Among the 30 patients with initial ophthalmopathy, severe

ophthalmopathy (5 of 30; p less than 0.05) and proptosis greater

than 20 mm 16 of 30; p less than 0.05) developed in significantly

more cases than in patients with no pretreatment ophthalmopathy. The

data suggest that hyperthyroid patients with pretreatment

ophthalmopathy are at risk for developing severe ophthalmopathy

after 131I treatment.

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