Cited by 228Ophthalmology and Eye DisordersThyroid Disorders and TreatmentsMyasthenia Gravis and Thymoma

The DOI matches its Crossref record.

Smoking and endocrine ophthalmopathy: impact of smoking severity and current vs lifetime cigarette consumption

Pfeilschifter, Johannes, Ziegler, Reinhard·1996·Clinical Endocrinology

DOI 10.1046/j.1365-2265.1996.8220832.x

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Abstract

OBJECTIVE Smoking has been associated with an increased incidence of endocrine ophthalmopathy (EO). In this study we examined the relation between smoking severity and the incidence of EO symptoms in patients with Graves’ hyperthyroidism. DESIGN Patients were prospectively followed for at least one year after the onset of hyperthyroidism. Smoking and EO status were evaluated at 3−6‐ months intervals. PATIENTS Two hundred and fifty‐three ambulatory patients with recent onset of Graves’ hyperthyroidism were studied. MEASUREMENTS The incidence of total EO symptoms, proptosis, and diplopia at any time point before and after the occurrence of Graves’ hyperthyroidism was assessed by interview and physical examination. RESULTS Smoking was associated with a 1.3‐fold increase in the overall incidence of symptomatic EO, and a 2.6 and 3.1‐fold increase in the incidence of proptosis and diplopia, respectively. The relative risk increased in parallel with the current number of cigarettes smoked per day. In contrast, lifetime tobacco use was not an independent risk factor for the development of EO symptoms. Former smokers had a significantly lower risk for the occurrence of proptosis and diplopia than active smokers with a comparable lifetime cigarette consumption. CONCLUSIONS Our data suggest that current, but not lifetime, tobacco consumption constitutes a risk for the incidence of proptosis and diplopia in patients with Graves’ hyperthyroidism, and that this risk increases with smoking severity.

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Items 101–200 of 228

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“…and bilateral procedures. e611 from other authors who reported a better outcome of correction of upper eyelid retraction in patients who smoked, in men, in patients with hypertension and in patients with more severe upper eyelid retraction (Prummel & Wiersinga 1993; Pfeilschifter & Ziegler 1996).”
Result
The Philosophy of Graves' Ophthalmopathy
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“…20 cigarettes daily had a relative risk of 7.0 (95% CI 3.0–16.5) for developing diplopia; in heavy ex-smokers who had quit their habit to smoke more than 20 cigarettes a day, the relative risk had decreased to 1.9 and was no longer significant (95% CI 0.5–7.7) (Pfeilschifter and Ziegler, 1996).”
BackgroundInfluential
Orbit and Orbital Apex
Robinson, D., Wilcsek, G., & Sacks, R. (2011) · Otolaryngologic Clinics of North America · doi:10.1016/j.otc.2011.06.011 · Cited by 14
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“1 factors such as cigarette smoking, poorly controlled thyroid dysfunction (both hyperthyroidism and hypothyroidism), and radioiodine (RAI) treatment.([1,2]) GO is an inflammation of extraocular muscles and peri-orbital connective tissue mediated by auto-antibodies against common antigens to both thyroid and orbit suc…”
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“11,12 Finally, cessation of smoking is associated with a lower risk for TED compared with current smoking.”
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Background
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Stannard, L., Slater, R. M., & Leatherbarrow, B. (2006) · European Journal of Anaesthesiology · doi:10.1017/s0265021505001900 · Cited by 10
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“Smoking cessation should be recommended to all patients; it is among the most important risk factors for TRO progression, with the effect being proportional to the number of cigarettes smoked daily.[6] Orbital imaging should be obtained with ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI).”
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Impact of tobacco on thyroid function
Balhara, Y. P. S., & Deb, K. (2014) · Thyroid Research and Practice · doi:10.4103/0973-0354.124187 · Cited by 9
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Method
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“In addition, there appears to be a dose-related response between the number of cigarettes smoked per day and the probability of developing GO.(38) Therefore, counseling to promote smoking cessation should take a central role in the management of all patients with GD.”
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“Moreover, smoking patients are less responsive to treatment than non-smokers [6, 7].”
Background
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“The smoking status was classiﬁed by the number of cigarettes smoked per day, according to a report by Pfeilschifter and Ziegler, as follows: 0, no smoking; 1, <10 cigarettes/day; 2, 10–20 cigarettes/day; and 3, >20 cigarettes/day [21].”
Method
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“Once individuals quit smoking, the negative effects on oph-thalmopathy appear to be reversible [27] (Fig.”
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“And, of course, all of the factors that potentiate the effects of hypoxia also play a role: smoking [18,19], diabetes and older patient age [20].”
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“Smokers usually exhibit a higher degree of TED severity [7,8,11,23].”
BackgroundMethod
Seminoma-associated orbitopathy mimicking thyroid-associated orbitopathy: report of a case and literature review
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“Although hypothyroidism and autoantibodies have de fi nitive role, smoking is a stronger risk factor for developing Graves’ ophthalmopathy and also worsening of the eye disease after RAIT [ 51, 52 ] .”
Background
[Endocrine ophthalmopathy. A visible psychophysical complaint].
Strempel, I. (2016) · PubMed · doi:10.1007/s00347-015-0212-6 · Cited by 2
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Ajjan, R., & Weetman, A. P. (2016) · Endocrinology · doi:10.1007/978-3-319-29195-6_3-1 · Cited by 3
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Rice, S., Sharaf, G., Kyriakakis, N., Korkontzelou, A., Katsaounou, P. A., & Tonstad, S. (2021) · European Respiratory Society eBooks · doi:10.1183/2312508x.10003220 · Cited by 2
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Quesada, M. I. Y., Curí, L. L., Marichal, I. I., Fernández, L. R., & Rodríguez, J. E. M. (2013) · Revista cubana de endocrinología · Cited by 2
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“▪ Raucher entwickeln schwerere Manifestationen [29], insbesondere Doppelbilder treten 6×häufiger auf [30].”
Background
Thyroid-Associated Ophthalmopathy and Dermopathy
Weetman, A. P. (1999) · Humana Press eBooks · doi:10.1007/978-1-59259-704-8_10 · Cited by 2
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“The smoking status was classified, based on the number of cigarettes smoked per day, as follows: 0, no smoking; 1, ˂ 10 cigarettes/day; 2, 10–20 cigarettes/day; and 3, ˃ 20 cigarettes/day [26].”
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Goldberg, R. A., & Rootman, D. B. (2014) · Springer eBooks · doi:10.1007/978-1-4939-1746-4_12 · Cited by 1
“As discussed in previous chapters, patients with Graves’ hyperthyroidism who smoke cigarettes have a higher incidence of TED [ 28 ].”
BackgroundResult
Thyroid Disruptors: How They Act and How We React
Elena, N. M., Silva, A. C. D. N., Bueno, R., Marcello, M. A., Leite, L. L., Cristina, E., & Sterian, L. A. (2011) · InTech eBooks · doi:10.5772/20904 · Cited by 1
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“6 times more common, respectively.(6) The smoking dose was also correlated with the development of GO.”
Background
Diagnostic approaches in a series of cases with Graves ophthalmopathy
Zosin, I. (2010) · Acta Endocrinologica (Bucharest) · doi:10.4183/aeb.2010.455 · Cited by 1
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Review Article THYROID ASSOCIATED OPHTHALMOPATHY - A REVIEW
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“The risk is proportional to the number of cigarettes smoked per day, and former smokers have a significantly lower risk than current smokers, even after adjusting for lifetime cigarette consumption.[7] Refraining from smoking might reduce the risk of developing GO.”
Background
Graves’ Ophthalmopathy
Bartalena, L. (2019) · Springer eBooks · doi:10.1007/978-3-319-72102-6_23 · Cited by 1
Thyroid Eye Disease
Wang, Y., & Douglas, R. S. (2022) · Springer eBooks · doi:10.1007/978-3-030-42634-7_61 · Cited by 1
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New insights into antibody-mediated hyperthyroidism
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Assessment and Management Plan for Graves’ Orbitopathy
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Dmuchowska, D. A. (2011) · DuEPublico (University of Duisburg-Essen)
Smoking and Prevention of Thyroid Eye Disease
Wiersinga, W. M. (2014) · Springer eBooks · doi:10.1007/978-1-4939-1746-4_5
“[ 18 ], the incidence of TED among current smokers, former smokers and never smokers was 68.”
BackgroundInfluential
Patogenia y tratamiento médico de la orbitopatía de graves
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“Varios trabajos han demostrado su efecto negativo, siendo significativamente mayor el número de pacientes fumadores con Orbitopatía de Graves que aquellos que no fuman y con una correlación positiva entre número de cigarrillos y severidad del compromiso ocular (2, 4, 5).”
Background
Declaración de consenso del Grupo europeo sobre la orbitopatía de Graves (EUGOGO) sobre el tratamiento de la orbitopatía de Graves (OG)
Bartalena, L., Baldeschi, L., Dickinson, A. J., Eckstein, A. K., Kendall‐Taylor, P., Marcocci, C., Mourits, M. P., Perros, P., Boboridis, K. G., Boschi, A., et al. (2008) · Endocrinología y Nutrición · doi:10.1016/s1575-0922(08)72796-7
The Clinical Characteristics of Thyroid Orbitopathy in Thyroid Dysfunction Pediatric Patients
Bae, J. B., Cheong, H. M., Yoo, J. H., Kwon, Y. H., & Ahn, H. B. (2013) · Journal of the Korean Ophthalmological Society · doi:10.3341/jkos.2013.54.8.1149
Ophthalmopathy Consciousness Level in Graves Patients: Graves Ophthalmopathy
Kan, E. K., Kan, E., Ecemiş, G. C., et al. (2014) · Erciyes Medical Journal · doi:10.5152/etd.2014.7982
“cigarettes smoked per day and GO development (11).”
Background
Natural History, Risk Factors, and Management of Patients with Mild GO
Stan, M. N. (2015) · Springer eBooks · doi:10.1007/978-1-4939-2534-6_18
“When Pfeilschifter and colleagues [ 38 ] looked at the correlation between number of cigarettes smoked per day and markers of GO severity they found a direct correlation with the risk for diplopia: relative risk 1.”
Background
Cigarette Smoking Has no Impact on the Effect of Radioiodine Therapy in Patients with Graves Disease
Sekulić, V., Rajic, M., Vlajković, M., et al. (2014) · AFMN Biomedicine · doi:10.1515/afmnai-2015-0007
“Cigarette smoking is a well recognized risk factor for the development of Graves’ hyperthyroidism (GH) and especially for Graves’ ophthalmopathy (GO) (5-9).”
BackgroundResult
Influence of cigarette smoking on thyroid gland — an update Wpływ palenia papierosów na tarczycę — aktualizacja
Sawicka‐Gutaj, N., Wender-Ożegowska, E., & Czarnywojtek, A. (2014)
General Management Plan for Graves' Orbitopathy
Bartalena, L. (2017) · KARGER eBooks · doi:10.1159/000475952
Update endokrine Orbitopathie
Eckstein, A. K., Oeverhaus, M., Stöhr, M., Dekowski, D., Berchner‐Pfannschmidt, U., Esser, J., Möller, L. C., & Führer‐Sakel, D. (2020) · Augenheilkunde up2date · doi:10.1055/a-1073-3799
“▪ Raucher entwickeln schwerere Manifestationen [29], insbesondere Doppelbilder treten 6 × häufiger auf [30].”
Background
Umwelteinflüsse auf das Immunsystem der Schilddrüse: lod und Rauchen
Quadbeck, B., & Eckstein, A. K. (2002) · De Gruyter eBooks · doi:10.1515/9783110877472.80
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Jun, B., & Subramanian, P. S. (2014) · Springer eBooks · doi:10.1007/978-1-4939-1746-4_10
Graves’ Disease
Saran, S. (2021) · IntechOpen eBooks · doi:10.5772/intechopen.98686 · Cited by 1
Graves’ Ophthalmopathy
Marcocci, C., & Smith, T. J. (2016) · Endocrinology · doi:10.1007/978-3-319-29195-6_16-1
Thyroid Eye Disease
Wang, Y., & Douglas, R. S. (2020) · Springer eBooks · doi:10.1007/978-3-319-90495-5_61-1

Authors: Pfeilschifter, J., & Ziegler, R.
Affiliations: Heidelberg University (DE)
Corresponding author: Pfeilschifter, Johannes
Venue: Clinical Endocrinology
Publisher: Wiley
Published: 1996-10
Volume: 45
Issue: 4
Pages: 477-481
ISSN: 0300-0664 (ISSN-L)
1365-2265
DOI: 10.1046/j.1365-2265.1996.8220832.x
OpenAlex: W1986559988
Cited by: 227
References: 0
Citations by year: 2026: 5 · 2025: 11 · 2024: 9 · 2023: 11 · 2022: 9 · 2021: 9 · 2020: 12 · 2019: 9 · 2018: 7 · 2017: 4 · 2016: 15 · 2015: 7 · 2014: 17 · 2013: 7 · 2012: 6
FWCI: 1.94
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 2584 d)
Locations: Clinical Endocrinology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Ophthalmology › Ophthalmology and Eye Disorders
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
Health Sciences › Medicine › Clinical Neurology › Myasthenia Gravis and Thymoma
Keywords: smoking, endocrine ophthalmopathy, Graves' hyperthyroidism, proptosis, diplopia, former smokers, risk factors
MeSH terms: Adult, Diplopia, Exophthalmos, Female, Graves Disease, Humans, Male, Middle Aged, Prospective Studies, Risk, Smoking, Incidence

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Smoking and endocrine ophthalmopathy: impact of smoking severity and current vs lifetime cigarette consumption

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