title: Antithyroid drug therapy for toxic diffuse goiter (Graves disease): thirty years experience in children and adolescents.
abstract: Since 1946 104 children and adolescents with toxic diffuse goiter have been treated. Sixty-seven were treated with a thioamide for more than 12 months. Remission occurred in 61%. Twenty-five patients had a 12-hour perchlorate discharge test to determine the least frequent dose schedule required for disease control: 68% could be controlled on a single daily dose and an additional 25% on an every 12-hour schedule. A one-hour radioiodine uptake on combined therapy and change in thyroid gland size during treatment were found to be highly correlated with the presence of a spontaneous remission. Thirty-six patients have been treated by subtotal thyroidectomy. To date 65% have developed permanent hypothyroidism. In the author's opinion, thoamides are the treatment of choice for the majority of children and adolescents.
mesh_terms: D000293:Adolescent; D013956:Antithyroid Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002231:Carbimazole / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006111:Graves Disease / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008713:Methimazole / Q000627:therapeutic use; D010472:Perchlorates / Q000627:therapeutic use; D011441:Propylthiouracil / Q000627:therapeutic use; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000187:drug effects; D013965:Thyroidectomy; D013974:Thyroxine / Q000097:blood / Q000627:therapeutic use
chemical_list: D013956:Antithyroid Agents; D010472:Perchlorates; D008713:Methimazole; D011441:Propylthiouracil; D002231:Carbimazole; D013974:Thyroxine