Milder clinical manifestations found in pediatric thyroid eye disease

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Recognizing subtle clinical differences between adult and pediatric patients with thyroid eye disease (TED) will help clinicians manage cases more effective, according to a study.

In this retrospective case series, 19 patients with pediatric TED with a median age at diagnosis of 12.5 years, were included. In 52.6% of the patients, TED and thyroid disease onset happened at the same time. Of these patients, all were hyperthyroid with the exception of one.

Symptoms reported at the time of TED diagnosis included proptosis (84.2%), lid retraction (63.2%), and acquired epiblepharon (63.2%). No patients had evidence of compressive optic neuropathy and all were inactive.

Over the 10-year study period, TED remained stable in all patients, with the exception of 1 patient who developed worsening proptosis with exposure keratopathy.

Orals and intravenous steroids were not prescribed to any patients, and no patients needed orbital decompression surgery.

Twelve patients developed acquired epiblepharon, requiring everting sutures in 1 patients and surgical correction in 3.

The authors concluded that pediatric TED exhibits milder clinical manifestations compared to adults.

Sim B, Chng CL, Audrey C, et al. A retrospective study of pediatric thyroid eye disease: the Asian experience. Orbit.https://doi.org/10.1080/01676830.2020.1831550

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