Table 1.

Evidence supporting a role of thyroglobulin in the pathogenesis of Graves’ ophthalmopathy

1. Thyroglobulin is a large and very antigenic protein and thecorresponding autoantibodies react with it in many clinical and experimental situations, so why not in the orbit?

2. Intact thyroglobulin can be detected in the orbits of patients with Graves’ ophthalmopathy so would be seen by circulating thyroglobulin antibodies

3. In patients with Graves’ hyperthyroidism, serum thyroglobulin levels correlate with the prevalence and severity of any associated ophthalmopathy

4. In patients with Graves’ ophthalmopathy, serum thyroglobulin levels correlate with serum titers of TSHr antibodies

5. In patients with Graves’ ophthalmopathy, serum thyroglobulin levels correlate with TSHr antibody titers, suggesting that both thyroid antigens are released at the same time

6. Thyroglobulin antibodies in the circulation and from the thyroid would bind to Tg in the orbit, although this has not been demonstrated

Abbreviation: TSHr, TSH receptor.