{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T06:59:56Z","timestamp":1781247596155,"version":"3.54.1"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Ophthalmol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To characterize the demographic characteristics, clinical features, and severity of thyroid eye disease (TED) in paediatric patients with Graves\u2019 disease for comparison with an adult cohort in the Kingdom of Bahrain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Paediatric patients (\u2264\u200918 years) with Graves\u2019 disease were screened for TED in Bahrain between October and December 2025. Paediatric endocrinologists across government, military, university, and private sectors participated. Patients were identified from physician-provided lists and verified using diagnostic codes and medical records from four nationwide centres. Comprehensive ophthalmic and orbital examinations were performed, and patients were classified into TED and non-TED groups. TED was diagnosed using the Bartley criteria and graded according to the European Group on Graves\u2019 Orbitopathy (EUGOGO) classification. Findings were compared with an adult Graves\u2019 disease cohort (&gt;\u200918 years) from the same population referred between September 2023 and December 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 22 paediatric patients with Graves\u2019 disease (median age 14 years, interquartile range [IQR] 10\u201316 years; female-to-male ratio 4:1), 11 (50%) were diagnosed with TED. No statistically significant differences were observed between patients with and without TED regarding demographic characteristics, smoking exposure, Graves\u2019 disease duration, family history of autoimmune thyroid disease, or hyperthyroidism treatment. However, parental consanguinity was significantly more common among patients with TED.<\/jats:p>\n                    <jats:p>Among paediatric TED patients, 54.5% had bilateral disease and 81.8% had mild TED. None had sight-threatening disease or diplopia. All patients were symptomatic, most commonly with periorbital bulging or swelling (81.8%). Lid retraction (72.7%) and proptosis (63.6%) were the most frequent objective findings, whereas extraocular motility restriction was uncommon (18.2%).<\/jats:p>\n                    <jats:p>\n                      Compared with adults (n\u2009=\u200981), mild disease was more frequent in paediatric patients (81.8% vs 48.1%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.04), whereas lid lag was more common in adults (64.2% vs 18.2%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study provides the first regional data on paediatric TED in the Gulf region, demonstrating that TED is common among children with Graves\u2019 disease and is predominantly mild in severity. Eyelid involvement and proptosis were the most frequent manifestations. Parental consanguinity was more common among children with TED, suggesting a possible genetic contribution. These findings emphasize the importance of routine ophthalmic screening in paediatric Graves\u2019 disease and highlight age-related differences in clinical presentation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10792-026-04128-1","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T06:18:55Z","timestamp":1781245135000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Thyroid eye disease in paediatric Graves\u2019 disease: a case series from the Gulf region with comparison to adults"],"prefix":"10.1007","volume":"46","author":[{"given":"Fatema Mohamed Ali Abdulla","family":"Aljufairi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth Ka Hei","family":"Lai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayed Fadhel Hashem Jaafar","family":"Neama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatema Hani Abdulla","family":"Saleh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khadija Ali","family":"Alola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fayza Ahmed","family":"Al-jenaidi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mansoor Hameed","family":"Rajab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maha Mahmood","family":"Alarayedh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wadeea Fareed","family":"Mohamed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebrahim Hassan","family":"Matar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wafa Fawzi","family":"Hassan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adel Salman","family":"Alsayyad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clement Chee Yung","family":"Tham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi Pui","family":"Pang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelvin Kam Lung","family":"Chong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"key":"4128_CR1","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1056\/NEJMra0905750","volume":"362","author":"RS Bahn","year":"2010","unstructured":"Bahn RS (2010) Graves\u2019 ophthalmopathy. 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