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Tocilizumab use in pediatric thyroid eye disease: First documented case
Safiya Albrashdi1, Hessah Alsharqi1, Fatima Habroosh1
1Sheikh Khalifa Medical City (SKMC), Al Karamah St - Al TibbiyaW13-01, Abu Dhabi, United Arab Emirates.
American Journal of Ophthalmology Case Reports
|February 24, 2022
Summary
Tocilizumab effectively treated a 9-year-old girl with rapidly worsening pediatric thyroid eye disease (TED). This novel treatment resolved proptosis and associated symptoms, offering a new therapeutic avenue for progressive TED.
Area of Science:
- Ophthalmology
- Endocrinology
- Immunology
Background:
- Pediatric thyroid eye disease (TED) can lead to significant morbidity.
- Progressive TED in children often presents diagnostic and therapeutic challenges.
- Current management strategies for severe pediatric TED are limited.
Observation:
- A 9-year-old female presented with hyperthyroidism and rapidly progressing bilateral proptosis, retrobulbar pain, and ocular inflammation.
- Initial management with observation and hyperthyroid control failed to halt disease progression.
- Exophthalmometry readings worsened from 21mm OD/17mm OS to 22mm OD/22mm OS over three months.
Findings:
- The patient received four monthly doses of Tocilizumab (8mg/kg).
- Significant improvement in proptosis was observed post-treatment.
- Resolution of retrobulbar pain, tearing, and conjunctival/caruncular redness occurred.
- Exophthalmometry readings improved to 20mm OD/19mm OS four months after treatment initiation.
Implications:
- This case suggests Tocilizumab is a potential treatment for progressive pediatric TED.
- Further research is warranted to evaluate Tocilizumab's efficacy and safety in pediatric TED.
- This opens a new therapeutic pathway for managing severe, progressive TED in children.
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