Fig. 1

Clinical course of the present case. Thyroid ophthalmopathy was developed after growth hormone replacement therapy and was then attenuated by discontinuation of growth hormone and glucocorticoid therapy. Serum IGF-I levels were elevated > + 2 SD matched for age and sex, and decreased to within the normal range after discontinuation of somatropin administration. The open circles with solid lines and closed circles with dashed lines present SD scores of IGF-I and serum free thyroxine levels, respectively. †, methyl prednisolone was administered as three courses of corticosteroid pulse therapy and was followed by oral prednisolone. Initial dose of oral prednisolone was 20 mg/day that was gradually decreased and was then discontinued on November 22, 2019. ‡, Activity of thyroid ophthalmopathy is presented as clinical activity score. Abbreviations: IGF-I, insulin-like growth factor-I.