CLINICAL STUDY Childhood Graves ’ ophthalmopathy: results of a European questionnaire study

Objective: Evaluation of the frequency of Graves ’ ophthalmopathy (GO) and its management in chil-dren and adolescents up to 18 years old with Graves ’ hyperthyroidism. Study design: This was a questionnaire study (QS) among members of the European Thyroid Associ-ation and the European Society for Paediatric Endocrinology. Approximately 300 QS were sent to members with electronic addresses and 110 QS were returned from 25 countries: 52 respondents said they had no experience with Graves ’ disease in this age group, but 67 respondents (23 paediatric and 44 adult endocrinologists) completed the QS. Results: Out of 1963 patients with juvenile Graves ’ hyperthyroidism seen by respondents in the last 10 years, 641 (33%) had GO; about one-third of GO cases were #10 years old, and two-thirds were 11–18 years old. The prevalences of GO among juvenile Graves ’ hyperthyroidism were 36.6, 27.3 and 25.9 % in countries in which the smoking prevalence among teenagers was $25, 20– 25 and,20 % respectively (P, 0.0001 by x 2 test). When confronted with the standard case of a 13-year-old girl with Graves ’ hyperthyroidism and moderately severe active GO, the diagnostic approach included on average 4.9 biochemical tests (TSH, free thyroxine (FT4) and TSH.R-Ab