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Eugenie Wei Ting Poh; Thyroid-associated orbitopathy in HIV patients.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5617.
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Graves' disease is a resurgent autoimmune condition which is known to occur during immune reconstitution in HIV patients who are on highly active anti-retroviral therapy (HAART). We report the clinical features and manifestations of thyroid-associated orbitopathy (TAO) in HIV patients with Graves' disease, and the clinical course of the disease with respect to their immune status. We identify the challenges faced by clinicians in the clinical management of these cases.
A retrospective case series of patients referred to the Oculoplastic clinic at Tan Tock Seng Hospital from 2015 to 2017. Retrospective case-note review was done to determine the time of onset of Graves' disease and thyroid-associated orbitopathy with respect to their immune recovery, namely the CD4+ T cell count, HIV viral load and the type of anti-retroviral therapy.
4 patients were diagnosed with thyroid-associated orbitopathy. All 4 developed Graves' disease after they had started anti-retroviral treatment and as part of the immune reconstitution process. They developed signs of thyroid-associated orbitopathy within 2 years of developing Graves' disease.
Thyroid-associated orbitopathy in HIV patients is not well-described in the literature. An increased understanding of the clinical course of thyroid-associated orbitopathy in HIV and its immunological processes may enable us to elucidate the pathophysiology and improve upon the treatment of thyroid-associated orbitopathy.
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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