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Bin Sun, Zhaoxia Zhang; 99Tcm-Octreotide Scintigraphy and occult active Thyroid-Associated Ophthalmopathy in Pediatric Patients. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5612. doi: https://doi.org/.
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As an autoimmune inflammatory disorder, the incidence of thyroid associated ophthalmopathy (TAO) in children and adolescents is very low and the clinical manifestation is usually mild, self-limited. Neither the NOSPECT classification nor the clinical activity score (CAS) used in adult TAO is validated in evaluation of TAO in pediatric patient. In this study, we aimed to evaluate 99Tcm-octreotide scintigraphy in pediatric patient with mild TAO in course of a longtime follow-up.
This retrospective study comprised 5 pediatric patients with mild TAO, and 2 healthy children as normal control. All cases were diagnosed in First Hospital of Shanxi Medical University from 07/2012 through 12/2017. All pediatric patients with TAO were treated with antithyroid drugs and support treatment, e.g. Selenium Yeast 25μg, Bid; Aescuven forte 150mg, Bid. 99Tcm-octreotide scintigraphy was detected during five years of follow-up.
All pediatric patients with TAO accompanied with hyperthyroid and bilateral involvement. Main symptoms of pediatric patients with mild TAO were eyelid retraction and exophthalmos. None had optic neurophathy and eye movement restriction. 99Tcm-octreotide scintigraphy was positive in pediatric patients with TAO with elevated uptake ration (UR) (P<0.05). During five years of follow-up, no progression was observed in all pediatric patients with TAO. While, 99Tcm-octreotide scintigraphy was still positive, without significant differences of UR compared with baseline (P>0.05).
The clinical manifestations of pediatric TAO were usually mild and self-limited. Eyelid retraction and exophthalmos were the most common features and bilateral involvement. 99Tcm-octreotide scintigraphy was positive in pediatric patients with mild TAO during a longtime follow-up, which suggested these patients have the ‘occult active TAO’ other than clinical release and still need follow-up periodically.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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