[Stimulation of endogenous TSH secretion and endocrine orbitopathy]

In 81 patients the thyrotoxicosis was controlled with antithyroid drugs only. Ophthalmopathy was seen in 53 patients when therapy was started. Patients with ophthalmopathy stage V or VI were excluded from this study. Maximal pathological eye signs were seen in 24 patients before starting therapy. Worsening occurred during treatment in 16 patients and some months after therapy was stopped in 13 patients. In summary, 40 patients passed a phase of subnormal thyroid hormone levels. Although stimulated, thyrotrophin secretion during this phase of antithyroid drug treatment took place in 19 patients a time related, reversible progression of endocrine ophthalmopathy was seen only in one subject. During medical treatment of a relapse in this patient worsening of eye signs had been seen once more despite thyrotrophin secretion was suppressed. The results are discussed in view of an immunologic concept of the pathogenesis of Graves' disease.