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Synchronous Triplanar Reconstruction Integrated with Color Doppler Mapping for Precise and Rapid Localization of Thyroid Lesions
Published on: February 9, 2024
Clinical Characteristics and Risk Factors of Pediatric Thyroid Eye Disease
Ritu R Sampige1, Dylan B McBee1, Lucy I Mudie1,2
1Department of Ophthalmology, Baylor College of Medicine, Houston, Texas.
Insights
Pediatric thyroid eye disease (TED) is more severe in children with autoimmune comorbidities. While often non-progressive, these children may experience delays in receiving essential ophthalmic care.
Area of Science:
- Ophthalmology
- Endocrinology
- Pediatrics
Background:
- Thyroid eye disease (TED) is a rare autoimmune condition affecting the eye socket.
- Characterizing TED in children is crucial for understanding its unique natural history and risk factors.
Purpose of the Study:
- To define the natural history and clinical features of TED in a pediatric cohort.
- To identify risk factors associated with TED onset and severity in children.
Main Methods:
- Retrospective cohort study of pediatric TED patients (2013-2023).
- Data collected included demographics, ocular findings, disease progression, and management.
- Statistical analyses included Mann-Whitney U test and chi-square test.
Main Results:
- 78 pediatric patients diagnosed with TED.
- Average age at diagnosis was 11.1 years; 78.2% were female.
- Hyperthyroidism (85.5%) and family history of autoimmune disease (57.1%) were common. Autoimmune comorbidities correlated with higher Clinical Activity Scores (CAS).
Conclusions:
- Children with autoimmune comorbidities present with more severe TED.
- Pediatric TED often follows a non-progressive course, typically not requiring surgery.
- Delays in ophthalmic care are a concern for pediatric TED patients.
Purpose:
To characterize the natural history and clinical characteristics of thyroid eye disease (TED) in a pediatric population and identify risk factors contributing to disease onset and severity.
Methods:
A retrospective cohort study was conducted among children diagnosed as having TED between 2013 and 2023 presenting to Texas Children's Hospital. Patient demographics, ocular examination findings, disease progression, and management were recorded across encounters. Descriptive statistical analyses, Mann-Whitney U test, and chi-square test were performed.
Results:
Seventy-eight patients met the inclusion criteria. The mean age of children at the time of TED diagnosis was 11.1 ± 3.8 years. Most children with TED were female (78.2%), White (66.7%), non-Hispanic or Latino/a (59.0%), and hyperthyroid (85.5%), and had a family history of autoimmune disease (57.1%). Patients had their initial ophthalmology visit 0.9 years after the onset of thyroid disease symptoms on average. A higher Clinical Activity Score (CAS) was recorded in patients with autoimmune comorbidities (P < .05).
Conclusions:
Children with an autoimmune comorbidity are more likely to present with more severe TED. Trends in CAS values across time are heterogenous in the pediatric sample, with the most common trend of decreasing CAS across encounters, although with limitations in the availability of documented CAS values. Children with TED typically follow a non-progressive clinical course without requiring surgical intervention but may face greater delays in receiving timely ophthalmic care for their symptoms.
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