{"id":1340,"date":"2026-01-24T08:35:20","date_gmt":"2026-01-24T08:35:20","guid":{"rendered":"https:\/\/peaceful-mccarthy.213-158-90-25.plesk.page\/index.php\/2026\/01\/24\/unusual-presentation-of-euthyroid-graves-ophthalmopathy-in-pregnancy\/"},"modified":"2026-01-24T08:35:20","modified_gmt":"2026-01-24T08:35:20","slug":"unusual-presentation-of-euthyroid-graves-ophthalmopathy-in-pregnancy","status":"publish","type":"post","link":"https:\/\/peaceful-mccarthy.213-158-90-25.plesk.page\/index.php\/2026\/01\/24\/unusual-presentation-of-euthyroid-graves-ophthalmopathy-in-pregnancy\/","title":{"rendered":"UNUSUAL PRESENTATION OF EUTHYROID GRAVES OPHTHALMOPATHY IN PREGNANCY"},"content":{"rendered":"<div class=\"article-authors\">Germain S.<sup>2<\/sup>, Dagdelen S.<sup>1<\/sup>, Saha S.<sup>2<\/sup>, Nelson-Piercy C.<sup>2<\/sup>, Stanford M.<sup>2<\/sup>, Gilbert J.<sup>1<\/sup>, Carrol P.<sup>2<\/sup><\/div>\n<div class=\"article-institutes\"><sup>1<\/sup>Endocrinology and Diabetes, King&rsquo;s College Hospital, London, UK, <sup>2<\/sup>Gynecology and Obstetrics, Guys and St Thomas, NHS Trust, London, UK<\/div>\n<div class=\"article-abstract\">\n<h2>Abstract<\/h2>\n<p><strong>Background:<\/strong> Euthyroid status is observed in &asymp; 20 % patients with Graves ophthalmopathy. During pregnancy, hyperthyroid Graves disease tends to improve during the course of gestation and may relapse post-partum. We report a case of a euthyroid patient presenting de novo with Graves ophthalmopathy during pregnancy which was successfully treated by steroid therapy. <br \/><strong>Case Report:<\/strong> A 23 year old primiparous, euthyroid, female presented at 30 weeks gestation with swelling and erythema of the left eye progressing to bilateral involvement. Orbital MRI revealed left sided proptosis and bilateral infiltration of the superior and inferior rectus muscles. She was managed conservatively. At 36 weeks gestation, she developed sudden loss of vision in the right eye: Visual acuity; 6\/12 left eye, hand movements right eye with bilateral ophthalmoplegia. Anti TPO (4 U\/ml), antiTg (O U\/ml) and total TSHR (5 U\/L) antibodies were not elevated. TSH receptor stimulating antibodies, measured by cAMP bio-assay 186pmol\/l neat (negative control: &lt; 5 pmol\/l), TSH binding inhibitory Ig assay 15 % inhibition (positive &gt; 10%). Methyl-prednisolone 1 g\/d, IV was administered for 3 days, followed by oral prednisolone. Twelve days after presentation, ophthalmoplegia, proptosis and visual acuities had improved (6\/4 left eye, 6\/18 right eye). Decompression surgery was not required. Labour was uneventful at 40 weeks of gestation. <br \/><strong>Conclusion:<\/strong> De novo presentation of Graves ophthalmopathy during pregnancy is very rare, especially in the context of euthyroidism. The clinical heterogeneity of Graves disease during pregnancy may occur secondary to alteration in the level or respective ratio of stimulating and blocking antibodies to the TSHR. In this case, functionally active antibodies to the TSHR were demonstrated using a cAMP bio-assay whereas a commercial TSHR antibody assay was negative. Fluctuations in antibodies to other autoantigens such as the IGF1R may also be important. <\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Germain S.2, Dagdelen S.1, Saha S.2, Nelson-Piercy C.2, Stanford M.2, Gilbert J.1, Carrol P.2 1Endocrinology and Diabetes, King&rsquo;s College Hospital, London, UK, 2Gynecology and Obstetrics, Guys and St Thomas, NHS Trust, London, UK Abstract Background: Euthyroid status is observed in &asymp; 20 % patients with Graves ophthalmopathy. During pregnancy, hyperthyroid Graves disease tends to improve <a class=\"read-more\" href=\"https:\/\/peaceful-mccarthy.213-158-90-25.plesk.page\/index.php\/2026\/01\/24\/unusual-presentation-of-euthyroid-graves-ophthalmopathy-in-pregnancy\/\">Read More<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[45,2,9],"tags":[],"class_list":["post-1340","post","type-post","status-publish","format-standard","hentry","category-volume-7-issue-3","category-journal-articles","category-volume-7"],"_links":{"self":[{"href":"https:\/\/peaceful-mccarthy.213-158-90-25.plesk.page\/index.php\/wp-json\/wp\/v2\/posts\/1340","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/peaceful-mccarthy.213-158-90-25.plesk.page\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/peaceful-mccarthy.213-158-90-25.plesk.page\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/peaceful-mccarthy.213-158-90-25.plesk.page\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/peaceful-mccarthy.213-158-90-25.plesk.page\/index.php\/wp-json\/wp\/v2\/comments?post=1340"}],"version-history":[{"count":0,"href":"https:\/\/peaceful-mccarthy.213-158-90-25.plesk.page\/index.php\/wp-json\/wp\/v2\/posts\/1340\/revisions"}],"wp:attachment":[{"href":"https:\/\/peaceful-mccarthy.213-158-90-25.plesk.page\/index.php\/wp-json\/wp\/v2\/media?parent=1340"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/peaceful-mccarthy.213-158-90-25.plesk.page\/index.php\/wp-json\/wp\/v2\/categories?post=1340"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/peaceful-mccarthy.213-158-90-25.plesk.page\/index.php\/wp-json\/wp\/v2\/tags?post=1340"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}