{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T11:01:32Z","timestamp":1776769292366,"version":"3.51.2"},"reference-count":20,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,11,16]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:p>Thyroid dermopathy (TD) and thyroid eye disease (TED) are rare clinical entities in patients with hypofunctional autoimmune thyroid disease; however, these can be present in patients with thyroid-stimulating immunoglobulin (TSI)\/anti-thyroid-stimulating hormone receptor (TSHR) antibodies. TED is believed to be associated with antibodies stimulating TSHRs and cross-talk with IGF-1 receptor (IGF-1R) pathway, prompting tissue proliferation. Teprotumumab (monoclonal antibody targeting IGF-1R) has been proven to improve symptoms of TED. It is proposed that TD share the same pathophysiology as TED. We present a case of a patient with hypofunctional autoimmune thyroid disease with high TSI\/anti-TSHR antibodies who experienced significant improvement of symptoms of both TED and TD after six doses of teprotumumab. We postulate that further studies regarding the efficacy of teprotumumab in patients with TD are needed.<\/jats:p>","DOI":"10.1136\/bcr-2024-260129","type":"journal-article","created":{"date-parts":[[2024,12,22]],"date-time":"2024-12-22T09:25:25Z","timestamp":1734859525000},"page":"e260129","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Thyroid dermopathy and thyroid eye disease associated with hypofunctional autoimmune thyroid disease with high TSI\/anti-TSHR antibodies improved with teprotumumab"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7811-9607","authenticated-orcid":false,"given":"Ewelina","family":"Niedzialkowska","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Beaumont Hospital Royal Oak, Royal Oak, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashbita","family":"Pokharel","sequence":"additional","affiliation":[{"name":"Department of Pathology, Beaumont Hospital Royal Oak, Royal Oak, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajaz","family":"Banka","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Endocrinology, Beaumont Hospital Royal Oak, Royal Oak, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,12,22]]},"reference":[{"key":"2025082802554769000_17.12.e260129.1","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-199401000-00001"},{"key":"2025082802554769000_17.12.e260129.2","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/j.beem.2011.10.001","article-title":"Thyroid dermopathy and acropachy","volume":"26","author":"Fatourechi","year":"2012","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"2025082802554769000_17.12.e260129.3","doi-asserted-by":"crossref","first-page":"1998","DOI":"10.1210\/jc.2016-1220","article-title":"Thyroid Stimulating Antibodies Are Highly Prevalent in Hashimoto\u2019s Thyroiditis and Associated Orbitopathy","volume":"101","author":"Kahaly","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"2025082802554769000_17.12.e260129.4","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2009.180"},{"key":"2025082802554769000_17.12.e260129.5","doi-asserted-by":"crossref","first-page":"1820","DOI":"10.1111\/exd.14402","article-title":"Local immune microenvironment of skin may play an important role in the development of pretibial myxedema","volume":"30","author":"Chen","year":"2021","journal-title":"Exp Dermatol"},{"key":"2025082802554769000_17.12.e260129.6","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-1580"},{"key":"2025082802554769000_17.12.e260129.7","doi-asserted-by":"crossref","unstructured":"Crespo-Trevino R , Schiffman J , Ugradar S , et al . Thyroid dermopathy responds to teprotumumab therapy. Endocrinol Diabetes Metab Case Rep 2022. doi:10.1530\/EDM-21-0201","DOI":"10.1530\/EDM-21-0201"},{"key":"2025082802554769000_17.12.e260129.8","first-page":"YD01","article-title":"Pretibial Myxedema Associated with Euthyroid Hashimoto\u2019s Thyroiditis: A Case Report","volume":"8","author":"Nair","year":"2014","journal-title":"J Clin Diagn Res"},{"key":"2025082802554769000_17.12.e260129.9","first-page":"331","article-title":"Hashimoto\u2019s thyroiditis with ophthalmopathy and dermopathy","volume":"45","author":"Sarkar","year":"1997","journal-title":"J Assoc Physicians India"},{"key":"2025082802554769000_17.12.e260129.10","doi-asserted-by":"publisher","DOI":"10.1210\/jc.87.2.438"},{"key":"2025082802554769000_17.12.e260129.11","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-011-9559-x"},{"key":"2025082802554769000_17.12.e260129.12","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-2077"},{"key":"2025082802554769000_17.12.e260129.13","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1007\/s00423-023-03153-3","article-title":"TSH receptor autoantibody levels post-total thyroidectomy in Graves\u2019 ophthalmopathy: a meta-analysis","volume":"408","author":"Anees","year":"2023","journal-title":"Langenbecks Arch Surg"},{"key":"2025082802554769000_17.12.e260129.14","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1007\/s12262-016-1516-8","article-title":"Regression of Ophthalmopathic Exophthalmos in Graves\u2019 Disease After Total Thyroidectomy: a Prospective Study of a Surgical Series","volume":"79","author":"Bhargav","year":"2017","journal-title":"Indian J Surg"},{"key":"2025082802554769000_17.12.e260129.15","doi-asserted-by":"crossref","DOI":"10.1210\/jcemcr\/luac037","article-title":"Teprotumumab for Treatment of Pretibial Myxedema","volume":"1","author":"Reyes","year":"2023","journal-title":"JCEM Case Rep"},{"key":"2025082802554769000_17.12.e260129.16","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(12)65533-5"},{"key":"2025082802554769000_17.12.e260129.17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1910434"},{"key":"2025082802554769000_17.12.e260129.18","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/S2213-8587(21)00056-5","article-title":"Teprotumumab for patients with active thyroid eye disease: a pooled data analysis, subgroup analyses, and off-treatment follow-up results from two randomised, double-masked, placebo-controlled, multicentre trials","volume":"9","author":"Kahaly","year":"2021","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2025082802554769000_17.12.e260129.19","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1089\/thy.2022.0251","article-title":"Management of Thyroid Eye Disease: A Consensus Statement by the American Thyroid Association and the European Thyroid Association","volume":"32","author":"Burch","year":"2022","journal-title":"Thyroid"},{"key":"2025082802554769000_17.12.e260129.20","doi-asserted-by":"crossref","DOI":"10.1016\/j.jaad.2022.06.706","article-title":"34839 Game-changer or flop: Teprotumumab may not provide lasting improvement of pretibial myxedema","volume":"87","author":"Emge","year":"2022","journal-title":"J Am Acad Dermatol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-260129","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:55:54Z","timestamp":1756374954000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-260129"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":20,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12,22]]},"published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1136\/bcr-2024-260129"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-260129","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12]]}}}