Thiazolidinedione induced thyroid associated orbitopathy

BACKGROUND: To describe an episode of thyroid associated orbitopathy (TAO) following the initiation of thiazolidinedione (TZD). CASE PRESENTATION: We report a female patient with a history of Graves' disease and stabilised thyroid associated orbitopathy for 2.5 years, who experienced rapid progression of TAO after the initiation of thiazolidinedione for glycemic control. Following the discontinuation of TZD, the patient experienced subsequent stabilisation of disease and normalization of vision. The medical history, ophthalmic findings, and clinical course are discussed. CONCLUSION: Thiazolidinediones may exacerbate TAO, and this should be taken into consideration when selecting treatment for diabetic patients with a history of autoimmune thyroid disorders.