Abstract：
To present 5 cases of alemtuzumab-induced thyroid eye disease (AI-TED) and review the literature to highlight the natural history, severity, and outcomes as compared with conventional thyroid eye disease (TED).
A multi-institutional retrospective case series of patients with AI-TED was compiled. Chart review evaluated for clinical characteristics, imaging findings, and treatment for AI-TED. Additionally, a comprehensive review of the literature identified all previously published cases of AI-TED.
Five new patients with AI-TED were included in this series. The average clinical activity score on presentation was 2.8 (range 1-4) and reached an average peak of 5.0 during the active phase of the disease (4-7). Patients were treated medically with selenium (40%) or monoclonal antibodies including teprotumumab or tocilizumab (40%). Surgical treatment with orbital decompression for compressive optic neuropathy was performed on 2 (40%) patients. Combined with 11 previously reported cases, these 16 patients with AI-TED had an average clinical activity score on presentation of 3.3. The average length of the AI-TED phase was 14.0 months, and all patients were treated with medical and/or surgical interventions for their disease.
Clinical and imaging findings in AI-TED mirror that of conventional TED, however, AI-TED may present with greater severity. AI-TED may develop many months after Graves\' disease; therefore, providers should be aware of this association and monitor patients for the development of severe TED.
A multi-institutional retrospective case series of patients with AI-TED was compiled. Chart review evaluated for clinical characteristics, imaging findings, and treatment for AI-TED. Additionally, a comprehensive review of the literature identified all previously published cases of AI-TED.
Five new patients with AI-TED were included in this series. The average clinical activity score on presentation was 2.8 (range 1-4) and reached an average peak of 5.0 during the active phase of the disease (4-7). Patients were treated medically with selenium (40%) or monoclonal antibodies including teprotumumab or tocilizumab (40%). Surgical treatment with orbital decompression for compressive optic neuropathy was performed on 2 (40%) patients. Combined with 11 previously reported cases, these 16 patients with AI-TED had an average clinical activity score on presentation of 3.3. The average length of the AI-TED phase was 14.0 months, and all patients were treated with medical and/or surgical interventions for their disease.
Clinical and imaging findings in AI-TED mirror that of conventional TED, however, AI-TED may present with greater severity. AI-TED may develop many months after Graves\' disease; therefore, providers should be aware of this association and monitor patients for the development of severe TED.
摘要：
目的：介绍5例阿仑珠单抗诱导的甲状腺眼病（AI-TED），并回顾文献以强调自然史，严重程度,以及与传统甲状腺眼病（TED）相比的结局。
方法：编制了AI-TED患者的多机构回顾性病例系列。评估临床特征的图表审查，影像学发现，和AI-TED的治疗。此外,对文献的全面审查确定了所有以前发表的AI-TED案例。
结果：本系列包括5名新的AI-TED患者。出现时的平均临床活动评分为2.8（范围1-4），在疾病的活动期（4-7）达到平均峰值5.0。患者接受硒（40％）或单克隆抗体（包括teprotumumab或托珠单抗（40％））的药物治疗。对2例（40％）患者进行了眼眶减压术治疗压缩性视神经病变。加上先前报告的11例病例，这16例AI-TED患者的平均临床活动评分为3.3.AI-TED阶段的平均时间为14.0个月，所有患者均接受内科和/或外科治疗.
结论：AI-TED的临床和影像学检查结果与传统TED的结果相似，然而,AI-TED可能会出现更严重的情况。AI-TED可能在格雷夫斯病后数月发展；因此，提供者应该意识到这种关联,并监测患者严重TED的发展.
方法：编制了AI-TED患者的多机构回顾性病例系列。评估临床特征的图表审查，影像学发现，和AI-TED的治疗。此外,对文献的全面审查确定了所有以前发表的AI-TED案例。
结果：本系列包括5名新的AI-TED患者。出现时的平均临床活动评分为2.8（范围1-4），在疾病的活动期（4-7）达到平均峰值5.0。患者接受硒（40％）或单克隆抗体（包括teprotumumab或托珠单抗（40％））的药物治疗。对2例（40％）患者进行了眼眶减压术治疗压缩性视神经病变。加上先前报告的11例病例，这16例AI-TED患者的平均临床活动评分为3.3.AI-TED阶段的平均时间为14.0个月，所有患者均接受内科和/或外科治疗.
结论：AI-TED的临床和影像学检查结果与传统TED的结果相似，然而,AI-TED可能会出现更严重的情况。AI-TED可能在格雷夫斯病后数月发展；因此，提供者应该意识到这种关联,并监测患者严重TED的发展.
