[The assessment of urinary glycosaminoglycans (GAG) excretion during therapy of patients with progressive Graves' ophthalmopathy].

Excessive accumulation of hydrophilic glycosaminoglycans (GAG) in the retrobulbar tissue leads to many of the clinical manifestations of Graves' ophthalmopathy (GO). We examined the quantitative urinary GAG excretion in 35 patients with GO. GAG were isolated from 24-h urine collections by precipitation with cetylpyridinum chloride and ethanol according to Bitter. Patients with progressive ophthalmopathy showed on the average a twofold increase in urinary GAG excretion in comparison to patients with stable ophthalmopathy. The elevated values of GAG decreased significantly under treatment and correlated with the clinical picture of GO, however no correlation was found between the urinary GAG values and actual severity of ophthalmopathy classified according to Werner and Donaldson. There was no significant difference in GAG excretion between group 1, treated with methylprednisolon and irradiation of retrobulbar tissue and group 2, under therapy with methylprednisolon. In conclusion, elevated urinary GAG excretion is characteristic for the clinical picture of the progressive GO. The remarkable decrease in GAG values during treatment correlated to the positive response to immunosuppressive therapy.