Contemporary diagnostic and therapeutic abilities in childhood thyroid-associated ophthalmopathy with a clinical case description.
BACKGROUND
Eye symptoms are comparatively frequent in the clinical evidence of Basedow's disease in childhood. Severe forms of thyroid-associated ophthalmopathy are casuistic in pediatric patients. Early diagnose and evaluation of the severity of thyroid orbitopathy and relevant specialist treatment are key prognostic factors according to the contemporary consensuses.


OBJECTIVE
The aim of the present study was to make a review of the contemporary diagnostic and therapeutic abilities in pediatric patients with Basedow's disease and thyroid-associated ophthalmopathy. We present a clinical case of severe TAO in an 11-year-old girl with Basedow's disease. The combined therapeutic scheme based on the EUGOGO (European Group on Graves' orbitopathy) consensus of 2008 includes not only thyrostatics but also local ophthalmic agents and pulse corticosteroid therapy, followed by an alternating dose regimen. The favourable outcome of the treatment is determined to a great extend by the close collaboration between the pediatric endocrinologist and the ophthalmologist.


CONCLUSIONS
It is concluded that children with thyroid-associated ophthlmopathy should promptly be referred to a specialized centre for evaluation of the severity of orbitopathy and an adequate therapy. This is of crucial importance for the preservation of patient's sight.
Kaleva
Nartzis N
NN
Clinic of Pediatric and Genetic Diseases Prof I. Andreev, University Hospital, Plovdiv, Bulgaria.
Pehlivanova
Neli I
NI
Misheva
Zlatka P
ZP
Shabanova
Tatyana D
TD
Balabanova
Anelia V
AV
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage; D000465:Algorithms; D013956:Antithyroid Agents / Q000008:administration & dosage; D002648:Child; D005260:Female; D049970:Graves Ophthalmopathy / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000319:Adrenergic beta-Antagonists; D013956:Antithyroid Agents