Thyroid eye disease causes and risk factors
Although there have been advances recently in knowledge of the mechanisms that cause thyroid eye disease, they are still largely unknown.
Mechanism of thyroid eye disease
It is considered an inflammatory autoimmune disease in which the immune system synthesizes antibodies that stimulate the thyroid gland and the eye socket tissues.
In this disease, the cell with which the immune system interacts is the fibroblast (a type of connective tissue cell). Lymphocytes (white blood cells) activate the fibroblasts and, as a result of this activation, some of these orbital fibroblasts differentiate into fat cells (adipocytes). This results in an increase in the space occupied by the fat in the orbit of the eyes and swelling of the eye.
One of the main risk factors associated with the disease is smoking. The association between smoking and thyroid eye disease is well established: smokers have more severe manifestations and respond less well to treatment; so stopping smoking reduces the risk of progression.
Another risk factor is radioactive iodine treatment; thyroid eye disease worsens in approximately 10-20% of patients undergoing this treatment. In susceptible individuals, iodine and drugs containing iodine may precipitate the onset or a recurrence of Graves' disease.
Other risk factors described are genetic predisposition and stress.
Although thyroid eye disease cannot be prevented, good hormone control by an endocrinologist is recommended. It is also recommended not to smoke so that the disease is milder.
Early diagnosis of thyroid eye disease can improve prognosis. The detection of possible complications associated with the disease can minimise its severity.
Substantiated information by:
Published: 14 June 2022
Updated: 22 October 2024
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