Thyroid peroxidase antibody positivity and triiodothyronine levels are associated with pediatric Graves' ophthalmopathy

Jung Hyun Lee, So Hyun Park, Dae Gyun Koh, Byung Kyu Suh

Gyeonggi-do, Korea

Author Affiliations: Department of Pediatrics, the Catholic University of Korea, St. Vincent's Hospital, 93-6, Ji-dong, Paldal-gu, Suwon-si, Gyeonggi-do, Republic of Korea (Lee JH, Park SH, Koh DG); Department of Pediatrics, the Catholic University of Korea, Seoul St. Mary's Hospital, 222 Banpo-daero, Seocho-gu, Seoul, Republic of Korea (Suh BK)

Corresponding Author: So Hyun Park, Department of Pediatrics, The Catholic University of Korea, St. Vincent Hospital, 93-6, Ji-dong, Paldal-gu, Suwon-si, Gyeonggi-do, Republic of Korea (Tel:+82 31 249 8312; Fax: +82 257 9111; Email: nicedoc@catholic.ac.kr)

doi: 10.1007/s12519-014-0476-y

Background: Graves' ophthalmopathy (GO) occurs commonly in children with Graves' disease (GD). However, there are limited studies on the clinical manifestations and thyroid autoantibodies in pediatric GO. The aim of this study was to investigate the prevalence and risk factors of GO in childhood GD.

Methods: Clinical and biochemical data from children and adolescents with GD were retrospectively reviewed. Eighty patients under 19 years of age were included in the present study. We compared the clinical and biochemical differences between patients with and without GO.

Results: Thirty-nine percent of the patients had GO, and 81% of the GO patients were females. Of these, two patients showed unilateral GO. Triiodothyronine (T3) levels were higher in GO patients than in those without GO. Anti-thyroglobulin antibody and thyroid stimulating hormone receptor antibody titers were not significantly different between the two groups. Anti-thyroid peroxidase antibody (TPO Ab) positivity was 68% in the patients with GO and only 47% in the patients without GO. In multivariate regression analysis, high T3 levels and TPO Ab positivity were related to the presence of GO.

Conclusion: In children and adolescents with GD, TPO Ab positivity and high T3 levels could act as predictive factors for the presence of GO.

Key words: Graves' disease; Graves' ophthalmopathy; pediatrics; thyroid peroxidase antibody; triiodothyronine

World J Pediatr 2014;10(2):155-159