Evaluation of diagnosis and treatment results in children with Graves' disease with emphasis on the pubertal status of patients.
This retrospective study evaluated the clinical and laboratory characteristics at presentation and treatment results of patients with Graves' disease (GD) with respect to pubertal status. Records of 143 patients (108 F, 35 M) were reviewed in a multicenter study. At diagnosis, 38% of patients were prepubertal. Anti-thyroid drugs (ATD) were used as initial therapy. There was no significant difference in clinical and laboratory characteristics at diagnosis, during treatment and adverse reaction to ATD with respect to pubertal status. Twenty patients (7 prepubertal, 13 pubertal) reached remission on ATD. Surgery was performed in seven and radioiodine (RAI) in four patients. Duration of treatment needed to achieve remission was longer in prepubertal (4.2 +/- 1.0 yr) than in pubertal patients (3.1 +/- 1.3 yr) (p = 0.02). The rate of remission was not different between prepubertal (25.9%) and pubertal patients (33.3%) (p = 0.59). ATD were associated with low remission rate in pediatric GD and required longer duration of therapy in prepubertal patients. For definitive treatment in older children, RAI could be evaluated as the initial therapy.
Poyrazoğlu
Sükran
S
Istanbul Faculty of Medicine, Istanbul University, Turkey. sukranpoyrazoglu@yahoo.com
Saka
Nurcin
N
Bas
Firdevs
F
Isguven
Pinar
P
Dogu
Aysegul
A
Turan
Serap
S
Bereket
A
A
Turan
Abdullah
A
Sarikaya
Sevil
S
Adal
Erdal
E
Cizmecioglu
Filiz
F
Cizmeci
Filiz
F
Saglam
Halil
H
Ercan
Oya
O
Memioglu
Nihal
N
Günöz
Hulya
H
Bundak
Ruveyde
R
Darendeliler
Feyza
F
Yildiz
Metin
M
Guran
Tulay
T
Akcay
Teoman
T
Akin
Leyla
L
Hatun
Sukru
S
D000293:Adolescent; D000465:Algorithms; D013956:Antithyroid Agents / Q000627:therapeutic use; D001837:Body Weights and Measures; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006111:Graves Disease / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D011627:Puberty / Q000502:physiology*; D012074:Remission Induction; D012189:Retrospective Studies
D013956:Antithyroid Agents