ĐẶC ĐIỂM, KẾT QUẢ ĐIỀU TRỊ BỆNH MẮT BASEDOW MỨC ĐỘ TRUNG BÌNH ĐẾN NẶNG BẰNG PHÁC ĐỒ GLUCOCORTICOID TĨNH MẠCH

Abstract

Objective: To describe the clinical and paraclinical characteristics and evaluate the treatment outcomes of moderate-to-severe active Graves’ orbitopathy using intravenous glucocorticoid therapy according to EUGOGO recommendations. Subjects and Methods: A prospective-retrospective descriptive study was conducted at the Department of Endocrinology, Bach Mai Hospital, from January 2023 to July 2025. A total of 32 patients with moderate-to-severe active Graves’ orbitopathy (CAS ≥ 3) were treated with intravenous methylprednisolone for at least 3 weeks. Treatment outcomes were assessed using the Clinical Activity Score (CAS), proptosis measurement, and other clinical parameters. Results: The mean patient age was 50.65 ± 11.27 years, with 56.25% being female. The most common symptoms were conjunctival hyperemia (90.6%) and eyelid swelling (90.6%). CAS decreased significantly from the first treatment week (p<0.01), while proptosis improved significantly only from week 3 (p=0.034). Univariate logistic regression suggested that higher initial CAS scores were associated with poorer treatment response. Adverse events occurred in 3 out of 32 patients (9.38%) and were manageable. Conclusion: Intravenous glucocorticoid therapy is effective in reducing inflammatory symptoms in moderate-to-severe Graves’ orbitopathy. However, treatment response may be delayed, especially regarding proptosis improvement. The use of concomitant immunosuppressive agents or biologics may be a future consideration in clinical practice.