- 著者
- Natsuko Watanabe Jaeduk Yoshimura Noh Ai Kozaki Ran Yoshimura Ai Yoshihara Nami Suzuki Masako Matsumoto Miho Fukushita Aya Kinoshita Azusa Aida Hideyuki Imai Shigenori Hiruma Toshu Inoue Kosuke Inoue Kiminori Sugino Koichi Ito
- 出版者
- The Japan Endocrine Society
- 雑誌
- Endocrine Journal (ISSN:09188959)
- 巻号頁・発行日
- vol.70, no.11, pp.1087-1096, 2023 (Released:2023-11-28)
- 参考文献数
- 40
Appropriate administration of anti-inflammatory and immunosuppressive treatment (AIIST) is important for patients with Graves’ orbitopathy (GO). This study aimed to clarify the incidence and risk factors for GO treated with AIIST and propose a predictive score, among newly diagnosed Graves’ disease (GD) patients in Japan. A total of 1,553 GD patients who were newly diagnosed during the year 2011 were investigated. AIIST included local and/or systemic glucocorticoid administration and retrobulbar irradiation. A multivariable Cox proportional hazards model was used to investigate the risk factors for GO underwent AIIST during medical treatment, including at diagnosis, of GD. Then, a GO score was created by summing each point assigned to risk factors based on their coefficient obtained in the Cox model. AIIST was administered to 107 patients (6.9%). The risk factors and hazard ratios for GO underwent AIIST were: age (per 10 years), 1.32 (95% confidence interval: 1.16–1.50), p < 0.0001; TSH binding inhibitory immunoglobulin (TBII) (per 10 IU/L), 1.33 (1.15–1.54), p = 0.0001; and thyroglobulin antibody (TgAb) negativity, 2.98 (1.96–4.59), p < 0.0001. The GO score, ranging from 0 to 8 points, showed moderate performance (area under the curve: 0.71, cut-off value: 5 points, sensitivity: 0.76, specificity: 0.59, positive predictive value: 0.12, negative predictive value: 0.97). AIIST was performed for patients with active manifestations of GO in 6.9% of newly diagnosed GD patients. The risk factors for GO underwent AIIST were higher age, higher TBII, and TgAb negativity. The GO score based on these factors may be useful in managing GO.
- 著者
- Marino Hiruma Natsuko Watanabe Takako Mitsumatsu Nami Suzuki Miho Fukushita Masako Matsumoto Ai Yoshihara Jaeduk Yoshimura Noh Kiminori Sugino Koichi Ito
- 出版者
- The Japan Endocrine Society
- 雑誌
- Endocrine Journal (ISSN:09188959)
- 巻号頁・発行日
- pp.EJ22-0319, (Released:2022-10-05)
- 被引用文献数
- 2
Graves’ disease has been reported to affect the clinical features of moyamoya disease (MMD), an occlusion of the circle of Willis. This study aimed to clarify the characteristics of MMD in patients with Graves’ disease. This was a single-center, retrospective study. The prevalence and clinical features of MMD patients among all patients with thyroid disease who visited Ito hospital from January 2005 to December 2019 were evaluated. The relationship between MMD and hyperthyroidism was analyzed in new-onset Graves’ disease patients during the same period. Of all 394,422 patients with thyroid disease, 88,180 had Graves’ disease, and 40 had MMD with Graves’ disease, i.e., the prevalence was 45.36 per 100,000 patients with Graves’ disease (0.0454%). The median age at onset of MMD was 39 years (interquartile range, 31–54 years), with a male to female ratio of 1:12. The most common time that MMD was diagnosed was within 1 year after the onset of Graves’ disease, in 9 of 40 patients (22.5%), and 19 of 40 patients (47.5%) underwent bypass surgery for MMD. In MMD with Graves’ disease, headache was the most frequent symptom, and ischemic types of stroke and bilateral lesions were common. Of 23,347 patients with new-onset Graves’ disease, 7 were diagnosed with MMD and the incidence of MMD was 5.94 patients per 100,000 person-years. Most patients developed MMD symptoms during hyperthyroidism. Although MMD is a rare condition, it should be noted that it can occur with Graves’ disease.