Alemtuzumab-induced TED may develop many months after Graves’ disease

Alemtuzumab-induced thyroid eye disease (AI-TED) may develop several months after Graves’ disease and can present with greater severity than conventional TED, according to a case series.

In this retrospective case series, the clinical characteristics, imaging findings, and treatment for 5 patients with AI-TED were reviewed.

At presentation, the average clinical activity score (CAS) was 2.8 (range 1-4). During the active phase, CAS reached an average peak of 5.0 (range 4-7). Patients were treated medically or with monoclonal antibodies. Two patients required orbital decompression for compressive optic neuropathy.

When combined with 11 cases of AI-TED identified in a comprehensive review of the literature, the average CAS of all 16 patients was 3.3 on presentation and the average length of the AI-TED phase was 14 months.

Reference
Nirmalan A, Blecher N, Hyder S, et al. Alemtuzumab-Induced Thyroid Eye Disease: A Comprehensive Case Series and Review of the Literature. Ophthalmic Plast Reconstr Surg. 2023;doi: 10.1097/IOP.0000000000002367. Epub ahead of print. PMID: 36893061.