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Hsu-Hua Tseng Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan

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Yen-Bo Lin Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan

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Kuan-Yu Lin Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin Branch, Douliu City, Taiwan

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Chia-Hung Lin Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu, Taiwan

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Hung-Yuan Li Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan

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Chia-Hsuin Chang Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan

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Yi-Ching Tung Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan

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Pei-Lung Chen Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Graduate Institute of Medical Genomics and Proteomics, National Taiwan University College of Medicine, Taipei, Taiwan
Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan

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Chih-Yuan Wang Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan

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Wei-Shiung Yang Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan

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Shyang-Rong Shih Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
Center of Anti-Aging and Health Consultation, National Taiwan University Hospital, Taipei, Taiwan

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( 22 ). Those with type 2 DM, gestational DM, or other types of DM were excluded. Overt hyperthyroidism is defined as elevated serum concentrations of thyroid hormones with suppressed serum thyroid-stimulating hormone (TSH) levels. Subclinical

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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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evaluate and manage. Novel therapies have recently emerged, and their specific roles are still being determined. Most patients with TED develop eye disease while being treated for hyperthyroidism under the care of endocrinologists. Endocrinologists

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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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Response options GD patients with mild active TED and a CAS of three points present a management challenge. Do you have a preference regarding first-line treatment for hyperthyroidism? Anti-thyroid drugs, radioiodine, radioiodine plus oral

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Joanna Bogusławska Centre of Postgraduate Medical Education, Department of Biochemistry and Molecular Biology, Warsaw, Poland

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Marlena Godlewska Centre of Postgraduate Medical Education, Department of Biochemistry and Molecular Biology, Warsaw, Poland

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Ewa Gajda Centre of Postgraduate Medical Education, Department of Biochemistry and Molecular Biology, Warsaw, Poland

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Agnieszka Piekiełko-Witkowska Centre of Postgraduate Medical Education, Department of Biochemistry and Molecular Biology, Warsaw, Poland

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hypothyroidism. In contrast, GD is mainly associated with hyperthyroidism, resulting from the presence of thyroid-stimulating antibodies which activate thyrotropin receptor (TSHR) on thyrocytes, leading to thyroid hyperplasia. Only a minor number of GD patients

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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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), which is corroborated by ongoing epidemiological studies, that link low Se status with an increased risk of HT and GD ( 6 , 13 , 14 , 15 , 16 , 17 ). A relationship between Se supply, thyroid disease risk (hyperthyroidism), and sexual dimorphism was

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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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whom characterized by Graves’ hyperthyroidism, caused by autoantibodies stimulating the thyrotropin receptor (TRAb) ( 3 ). However, TRAb that developed following ALTZ may also exert a blocking activity on the thyrotropin receptor, causing hypothyroidism

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Paneeraq Noahsen Arctic Health Research Centre, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Ilisimatusarfik, University of Greenland, Nuuk, Greenland
National Board of Health, Nuuk, Greenland

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Karsten F Rex Arctic Health Research Centre, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Ilisimatusarfik, University of Greenland, Nuuk, Greenland
Department of Internal Medicine, Queen Ingrid’s Hospital, Nuuk, Greenland

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Inge Bülow Pedersen Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark

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Gert Mulvad Ilisimatusarfik, University of Greenland, Nuuk, Greenland
Queen Ingrid’s Health Care Centre, Nuuk, Greenland

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Hans Christian Florian-Sørensen Tasiilaq Health Care Center, Tasiilaq, Greenland

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Michael Lynge Pedersen Steno Diabetes Center Nuuk, Nuuk, Greenland

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Stig Andersen Arctic Health Research Centre, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Ilisimatusarfik, University of Greenland, Nuuk, Greenland
Department of Internal Medicine, Queen Ingrid’s Hospital, Nuuk, Greenland
Department of Geriatric Medicine, Aalborg University Hospital, Aalborg, Denmark

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thyroid disease  Hypothyroidism 4 0.9 1 0.7 2 1.4 1 0.7  Hyperthyroidism 5 1.2 1 0.7 2 1.4 2 2.1  Unknown 31 7.1 16 10.7 14 9.9 1 0.7  No 394 90.8 132 88

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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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of now, there have been no published cases on the therapeutic potential of diuretics in the management of DON. Case report A 69-year-old man was referred to our Thyroid Eye Clinic for progressive TED. Graves’ hyperthyroidism and atrial

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Luigi Bartalena University of Insubria, Varese, Italy

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diagnosed Graves' hyperthyroidism seen at a single center . Journal of Clinical Endocrinology and Metabolism 2013 98 1443 – 1449 . ( https://doi.org/10.1210/jc.2012-3873 ) 5 Bartalena L Kahaly GJ Baldeschi L Dayan CM Eckstein A Marcocci C

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Petros Perros Department of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, UK

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Laszlo Hegedüs Department of Endocrinology Odense University Hospital, Odense, Denmark

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and Metabolism 2013 98 145 – 152 . ( https://doi.org/10.1210/jc.2012-3119 ) 6 Brandt F Thvilum M Hegedus L & Brix TH . Hyperthyroidism is associated with work disability and loss of labour market income. A Danish register-based study in

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