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Liliana Ribeiro Santos Internal Medicine Department, Hospital of Santa Maria, Lisbon, Portugal
Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal

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Inês Vasconcelos Bessa Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal
Health Investigation and Innovation Institute (i3S), University of Porto, Porto, Portugal

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Adriana Gaspar da Rocha Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal
Health Investigation and Innovation Institute (i3S), University of Porto, Porto, Portugal
Public Health Unit, ACES Baixo Mondego, Coimbra, Portugal

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Celestino Neves Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal
Department of Endocrinology, Hospital University Centre of São João, Porto, Portugal

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Cláudia Freitas Department of Endocrinology, Hospital University Centre of Porto, Porto, Portugal

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Paula Soares Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal
Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal
Health Investigation and Innovation Institute (i3S), University of Porto, Porto, Portugal
Department of Pathology, Faculty of Medicine of the University of Porto, Porto, Portugal

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scarcely found in diet, but are often found in soils, and used in supplementation ( 23 ). Current international guidelines do not yet recommend inclusion of Se-Su in the treatment of HT and GD without eye involvement, but the European Thyroid Association

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Jingyue Chen Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, Shenyang, China

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Chenyan Li Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, Shenyang, China

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Weiping Teng Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, Shenyang, China

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Zhongyan Shan Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, Shenyang, China

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Jun Jin Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Yining Wei Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Jing Sun Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Yushu Li Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, Shenyang, China

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Huifang Zhou Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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guidelines for GO ( 9 ). The guidelines were updated in 2021 ( 10 ). In 2022, the American Thyroid Association (ATA) and the ETA jointly published a consensus statement for TED ( 11 ). These guidelines and consensus statements provide reliable and

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Liyun Shen Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Lei Ye Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Wei Zhu Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Qin Jiao Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

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Yulin Zhou Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Shu Wang Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Weiqing Wang Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Guang Ning Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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, 5 , 6 ), guidelines recommended that a 4.5 g weekly pulse i.v. methylprednisolone (ivMP) remains to be the more accessible and cost-effective choice for active and moderate-to-severe GO patients currently ( 7 ). In previous studies, the response

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Jacopo Manso Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
Department of Women’s and Children’s Health, Pediatric Endocrinology Unit, Padua University Hospital, Padua, Italy

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Simona Censi Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy

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Cristina Clausi Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy

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Ilaria Piva Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy

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Yi Hang Zhu Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy

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Alberto Mondin Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy

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Maria Chiara Pedron Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy

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Susi Barollo Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy

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Loris Bertazza Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy

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Giulia Midena Department of Molecular Medicine, University of Padua, Padua, Italy

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Raffaele Parrozzani Department of Ophthalmology, University of Padua, Padua, Italy

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Caterina Mian Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy

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TED into mild, moderate-to-severe and sight-threatening. The most recent EUGOGO guidelines confirm the clinical activity score (CAS), proposed by Mourits et al. ( 9 ), as the best-validated scoring system for evaluating disease activity ( 7 ). TED is

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Luigi Bartalena University of Insubria, Varese, Italy

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placebo, unresponsive to teprotumumab or flaring after teprotumumab, confirmed the short-term effectiveness of teprotumumab ( 13 ). Last year, the European Group on Graves’ Orbitopathy (EUGOGO) Guidelines recommended ivGCs ± mycophenolate (an

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Ilaria Muller Department of Clinical Sciences and Community Health, University of Milan, Italy
Endocrinology Unit, Graves’ Orbitopathy Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

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Sara Maioli Department of Clinical Sciences and Community Health, University of Milan, Italy

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Mirco Armenti Department of Clinical Sciences and Community Health, University of Milan, Italy

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Laura Porcaro Department of Clinical Sciences and Community Health, University of Milan, Italy

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Nicola Currò Endocrinology Unit, Graves’ Orbitopathy Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
Ophthalmology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

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Elisabetta Iofrida Department of Specialistic Surgical Sciences, Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

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Lorenzo Pignataro Department of Clinical Sciences and Community Health, University of Milan, Italy
Department of Specialistic Surgical Sciences, Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

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Jacopo Manso Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy

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Caterina Mian Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy

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Jens Geginat Department of Clinical Sciences and Community Health, University of Milan, Italy
National Institute of Molecular Genetics (INGM) “Romeo and Enrica Invernizzi”, Milan, Italy

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Mario Salvi Endocrinology Unit, Graves’ Orbitopathy Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

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was referred to the combined thyroid-eye clinic of our TED Centre at the Endocrinology Department of Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico (Milan, Italy). TED activity and severity were defined according to the EUGOGO Guidelines ( 8

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Annamaria Erdei Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

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Annamaria Gazdag Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

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Bernadett Ujhelyi Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

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Edit B Nagy Division of Radiology and Imaging Science, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

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Ervin Berenyi Division of Radiology and Imaging Science, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

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Eszter Berta Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

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Zita Steiber Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

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Sandor Barna Division of Nuclear Medicine, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

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Emese Mezosi First Department of Internal Medicine, University of Pecs Medical School, Pecs, Hungary

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Miklos Bodor Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

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Endre V Nagy Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

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. Discussion Based on current guidelines ( 1 ), the suggested therapeutic approach to DON is high-dose i.v. corticosteroids which may result in complete visual recovery in 43% of cases ( 6 ). If there is no improvement in visual acuity, orbital bony

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Henry B Burch National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
Endocrinology Division, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland, USA

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Petros Perros Department of Endocrinology, Leazes Wing, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom

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Tomasz Bednarczuk Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland

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David S Cooper Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

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Peter J Dolman Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada

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Angela M Leung Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, UCLA David Geffen School of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA

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Ilse Mombaerts Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium

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Mario Salvi Department of Clinical and Community Services, Graves’ Orbitopathy Center, Endocrinology, Fondazione IRCCS Cà Granda, Milan, Italy

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Marius N Stan Division of Endocrinology, Diabetes and Metabolism, Mayo Clinic, Rochester, Minnesota, USA

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the ATA and ETA on conflicts of interest ( https://www.thyroid.org/wp-content/uploads/members/fin-disclosure-coi-policies-2018.pdf ; https://www.eurothyroid.com/files/download/ETA-Rules-for-Guidelines-2016.pdf ). Cochairs were nominated by ATA and ETA

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Haitao Zhang Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Hao Hu Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Yueyue Wang Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Xinjie Duan Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Lu Chen Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Jiang Zhou Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Wen Chen Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Weizhong Zhang Department of Ophthalmology, The Friendship Hospital of Ili Kazakh Autonomous Prefecture Ili & Jiangsu Joint Institute of Health, Ili, China
Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Xiaoquan Xu Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Huanhuan Chen Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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cholesterol and TED. The 2021 EUGOGO guidelines suggested that high serum cholesterol is an emerging and potential risk factor for TED ( 6 ). Previous studies have reported that the presence of TED correlates with hypercholesterolemia in patients with Graves

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Renaud Ciappuccini Department of Nuclear Medicine and Thyroid Unit, François Baclesse Cancer Centre, Caen, France
INSERM 1086 ANTICIPE, Caen University, Caen, France

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Virginie Saguet-Rysanek Department of Pathology, François Baclesse Cancer Centre, Caen, France

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Marine Dorbeau Department of Pathology, François Baclesse Cancer Centre, Caen, France

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Justine Lequesne Department of Clinical Research, François Baclesse Cancer Centre, Caen, France

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Camille Linard Department of Pathology, François Baclesse Cancer Centre, Caen, France

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Sophie Lefevre-Arbogast Department of Clinical Research, François Baclesse Cancer Centre, Caen, France

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Bénédicte Clarisse Department of Clinical Research, François Baclesse Cancer Centre, Caen, France

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Stéphane Bardet Department of Nuclear Medicine and Thyroid Unit, François Baclesse Cancer Centre, Caen, France

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L Carrió Gasset I Hindié E Huellner MW Luster M Piccardo A Weber T Talbot JN Verburg FA . The EANM practice guidelines for parathyroid imaging . European Journal of Nuclear Medicine and Molecular Imaging 2021 48 2801 – 2822

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