الفهرس 
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Abstract
It is often difficult however to distinguish inflammatory from non inflammatory Graves? disease , therefore a classification system for the disease activity of Graves? ophthalmopathy was done by Mourites et al, (1998) which is easily manageable and entirely clinical , making it applicable without the use of special instruments. Ten factors based up on the classic symptoms and signs of inflammation ( as pain, redness, (CAS), each factor carrying equal weighting. A score of 4 or more on the CAS predicts a significantly greater response to immunosuppressant . Our results showed no significant difference in clinical symptoms and signs of Graves? disease between active and inactive groups. Also there was no statistical difference in thyroid function tests between the tow groups of the patients . However, there was high incidence of smoking among male patients with active Graves? ophthalmopathy and short disease duration. Using orbital U.S., 70% of our patients with active Graves? ophthalmopathy have low extraoccular muscle reflectivity. Also there were singinificant elevation of CAS, sICAM1, IL2 and gcsIFN in patient with Positive U.S. compared to those with negative U.s. in active Graves? ophthalmopathy. Serum levels of sICAM1 were significantly high in Patients with Graves? disease than controls. Moreover it is more higher in patients with active Graves? ophthalmopathy. Also sICAM1 levels were positively correlated with the clinical activity score suggesting that these levels may be considered a useful marker of retro orbital enedothelial and fibroblast activation. However no significant correlation was found between sICAM1 and thyroid hormone levels. In addition we found significantly high level of both IL2 and gcsIFN in patient with active Graves? ophthalmopathy than inactie one. Also they positively correlated with sICAM1 level and CAS. Lastly we can conclude that CAS is good tool for differentiation between active and inactive Graves? ophthalmopathy and can be strengthened by orbital U.S. as well as sICAM1 , IL2 and gcsIFN. On the other hand, T cell subsets were found to be of little help in differentiation between active and inactive disease status.