[Euthyroid Graves' disease (problems of diagnosis and treatment)]

Twenty-six patients with endocrine ophthalmopathy without signs of thyroid disease (according to ultrasonic scanning, measurements of free thyroxin and thyrotropic hormone-TTH) were examined. Edematous exophthalmos in the compensated stage was diagnosed in 13 patients, subclinical stage of this condition in 10, and endocrine myopathy in 3 patients. Russian drug thyroliberin was used for accurate diagnosis of thyroid dysfunction; injection of this drugs to normal subjects leads to a drastic (3.5-5-fold) increase of TTH level. After measurement of TTH, the drug was infused intravenously by jet injection in a dose of 500 micrograms. Ten normal subjects were controls. 30 min after thyroliberin injection, TTH was measured. It was sharply increased in half of patients and in the control group. In one-third of cases (mainly with edematous exophthalmos) TTH level increased negligibly or even decreased after the test. After 1.5-2 years, signs of hyperthyrosis manifested in one-third of this group of patients. The authors consider that patients with the so-called Graves' disease are at a high risk of thyroid abnormalities and should be regularly consulted by both ophthalmologist and endocrinologist.