Predictive score for the development or progression of Graves' orbitopathy in patients with newly diagnosed Graves' hyperthyroidism.

Autor:	Wiersinga W; Department of Endocrinology and MetabolismAcademic Medical Center, University of Amsterdam, Amsterdam, Netherlands., Žarković M; Department of EndocrinologySchool of Medicine, University of Belgrade, Belgrade, Serbia milos.zarkovic@med.bg.ac.rs., Bartalena L; Endocrine UnitOspedale di Circolo., Donati S; Department of Medical and Surgical SciencesSchool of Medicine, University of Insubria, Varese, Italy., Perros P; Department of EndocrinologyRoyal Victoria Infirmary, Newcastle upon Tyne, UK., Okosieme O; Department of EndocrinologyInstitute of Molecular and Experimental Medicine, Cardiff University School of Medicine, Cardiff, UK., Morris D; Cardiff Eye UnitUniversity Hospital of Wales, Cardiff, UK., Fichter N; Department of OphthalmologyInterdisciplinary Centre for Graves' Orbitopathy, Olten, Switzerland., Lareida J; Department of OphthalmologyInterdisciplinary Centre for Graves' Orbitopathy, Olten, Switzerland., von Arx G; Department of OphthalmologyInterdisciplinary Centre for Graves' Orbitopathy, Olten, Switzerland., Daumerie C; Department of EndocrinologyUniversité Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium., Burlacu MC; Department of EndocrinologyUniversité Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium., Kahaly G; Department of Medicine IJohannes Gutenberg University Medical Center, Mainz, Germany., Pitz S; Orbital CenterOphthalmic Clinic, Buergerhospital, Frankfurt, Germany., Beleslin B; Department of EndocrinologySchool of Medicine, University of Belgrade, Belgrade, Serbia., Ćirić J; Department of EndocrinologySchool of Medicine, University of Belgrade, Belgrade, Serbia., Ayvaz G; Departments of Endocrinology and MetabolismFaculty of Medicine, Gazi University, Ankara, Turkey., Konuk O; OphthalmologyFaculty of Medicine, Gazi University, Ankara, Turkey., Törüner FB; Departments of Endocrinology and MetabolismFaculty of Medicine, Gazi University, Ankara, Turkey., Salvi M; Graves' Orbitopathy UnitDepartment of Clinical Science and Community Health, Fondazione Ca'Granda IRCCS, University of Milan, Milan, Italy., Covelli D; Graves' Orbitopathy UnitDepartment of Clinical Science and Community Health, Fondazione Ca'Granda IRCCS, University of Milan, Milan, Italy., Curro N; Department of OphthalmologyFondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy., Hegedüs L; Department of Endocrinology and MetabolismOdense University Hospital, University of Southern Denmark, Odense, Denmark., Brix T; Department of Endocrinology and MetabolismOdense University Hospital, University of Southern Denmark, Odense, Denmark.
Jazyk:	angličtina
Zdroj:	European journal of endocrinology [Eur J Endocrinol] 2018 Jun; Vol. 178 (6), pp. 635-643. Date of Electronic Publication: 2018 Apr 12.
DOI:	10.1530/EJE-18-0039
Abstrakt:	Objective: To construct a predictive score for the development or progression of Graves' orbitopathy (GO) in Graves' hyperthyroidism (GH). Design: Prospective observational study in patients with newly diagnosed GH, treated with antithyroid drugs (ATD) for 18 months at ten participating centers from EUGOGO in 8 European countries. Methods: 348 patients were included with untreated GH but without obvious GO. Mixed effects logistic regression was used to determine the best predictors. A predictive score (called PREDIGO) was constructed. Results: GO occurred in 15% (mild in 13% and moderate to severe in 2%), predominantly at 6-12 months after start of ATD. Independent baseline determinants for the development of GO were clinical activity score (assigned 5 points if score > 0), TSH-binding inhibitory immunoglobulins (2 points if TBII 2-10 U/L, 5 points if TBII > 10 U/L), duration of hyperthyroid symptoms (1 point if 1-4 months, 3 points if >4 months) and smoking (2 points if current smoker). Based on the odds ratio of each of these four determinants, a quantitative predictive score (called PREDIGO) was constructed ranging from 0 to 15 with higher scores denoting higher risk; positive and negative predictive values were 0.28 (95% CI 0.20-0.37) and 0.91 (95% CI 0.87-0.94) respectively. Conclusions: In patients without GO at diagnosis, 15% will develop GO (13% mild, 2% moderate to severe) during subsequent treatment with ATD for 18 months. A predictive score called PREDIGO composed of four baseline determinants was better in predicting those patients who will not develop obvious GO than who will. (© 2018 European Society of Endocrinology.)
Databáze:	MEDLINE
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