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Generation of a Mouse Spontaneous Autoimmune Thyroiditis Model
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Thyroid antibody-negative euthyroid Graves' ophthalmopathy.

Arshiya Tabasum1, Ishrat Khan1, Peter Taylor2

  • 1Department of Diabetes and Endocrinology , Prince Charles Hospital, Cwm Taf Health Board, Merthyr Tydfil , UK.

Endocrinology, Diabetes & Metabolism Case Reports
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Euthyroid Graves

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Area of Science:

  • Endocrinology
  • Ophthalmology

Background:

  • TSH receptor antibodies (TRAbs) are key to Graves' disease diagnosis.
  • Euthyroid Graves' ophthalmopathy (EGO) can be challenging when TRAbs are negative.

Purpose of the Study:

  • To report a case of EGO presenting with negative TRAbs.
  • To highlight diagnostic considerations for EGO.

Main Methods:

  • Case report of a 66-year-old female with eye symptoms and negative TRAbs.
  • Orbital CT and MRI scans were performed.
  • Diagnosis of Graves' ophthalmopathy (GO) based on clinical and imaging findings.
  • Surgical intervention for symptom relief.

Main Results:

  • The patient presented with eye pain and diplopia, but normal thyroid function and negative TRAbs.
  • Imaging confirmed orbital muscle thickening consistent with GO.
  • Surgical treatment resolved symptoms.
  • The patient later developed positive TRAbs and overt hyperthyroidism, responding to thionamide treatment.

Conclusions:

  • Euthyroid Graves' ophthalmopathy can initially present with negative thyroid autoantibodies.
  • Ophthalmopathy evaluation with imaging is crucial even with normal thyroid function and antibody tests.
  • Long-term follow-up is essential as thyroid dysfunction may develop later in EGO patients.