Pediatric Graves' disease: outcome and treatment.
Graves' disease treatment in children and adolescents includes antithyroid drugs (ATD), 131I (RI) or subtotal thyroidectomy (CX), all of which present beneficial effects and disadvantages.


OBJECTIVE
To review our experience in the management of pediatric patients with Graves' disease considering the therapeutic strategies used.


METHODS
Clinical and biochemical data of 116 children (23 boys) aged 11.2 +/- 3.7 years at diagnosis were reviewed. Outcome and remission were evaluated and persistency at 10 years calculated with Kaplan Meier analysis.


RESULTS
Initially 113/116 patients received ATD, two RI and one CX. After 10 years of follow up, 38 remitted with ATD, 23 were persistently hyperthyroid with ATD, 38 received RI, one underwent CX, and 13 were lost to follow up. The cumulative proportion with persistent hyperthyroidism at 10 years was 31%.


CONCLUSIONS
ATD, although the first choice of treatment, was long-lasting and achieved a low remission rate at 10 years of follow up. Conversely, RI was shown to be a safe, low cost, efficient and definitive alternative for Graves' disease treatment in children and adolescents.
Gruñeiro-Papendieck
Laura
L
División de Endocrinología, Hospital de Niños R. Gutierrez, Buenos Aires, Argentina. achiesa@cedie.org.ar
Chiesa
Ana
A
Finkielstain
Gabriela
G
Heinrich
Juan Jorge
JJ
D000293:Adolescent; D013956:Antithyroid Agents / Q000009:adverse effects / Q000627:therapeutic use; D001827:Body Height / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D005094:Exophthalmos / Q000150:complications / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006111:Graves Disease / Q000150:complications / Q000628:therapy*; D006801:Humans; D007457:Iodine Radioisotopes / Q000191:economics / Q000627:therapeutic use; D007518:Isoantibodies / Q000097:blood; D008297:Male; D011627:Puberty / Q000502:physiology; D012189:Retrospective Studies; D013965:Thyroidectomy / Q000009:adverse effects; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D013997:Time Factors; D016896:Treatment Outcome; D014284:Triiodothyronine / Q000097:blood
D013956:Antithyroid Agents; D007457:Iodine Radioisotopes; D007518:Isoantibodies; C035678:anti-Thy antibody; D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine