Thyroid-associated orbitopathy developed during hormone replacement therapy

Thyroid-associated orbitopathy (TAO) developed in relation to estrogen combined with progesterone therapy has not been reported previously. We report a case of a 56-year-old postmenopausal woman who during estrogen/progesterone treatment developed signs and symptoms of orbitopathy. The patient had no previous history of autoimmune- or thyroid disorders. The initial eye symptoms disappeared after withdrawal of hormone replacement therapy. Five years later estrogen/progesterone treatment was re-instituted. The patient had relapse of orbitopathy. The hormones were discontinued and the eye symptoms disappeared again. This suggests that estrogen and/or progesterone could be of some pathogenetic importance in the induction of orbitopathy