title: Clinical experience with radioactive iodine in the treatment of childhood and adolescent Graves' disease.
abstract: OBJECTIVE
  Treatments for Graves' disease (GD) in children and adolescents include oral antithyroid drugs (ATDs), near total thyroidectomy, and radioactive iodine (RAI). ATDs remain the preferred choice in this age group, but because persistent remission occurs in 30% of cases, RAI is becoming a common option for definitive therapy.
  
  
  METHODS
  We performed a review of 65 medical records of GD patients under age 19 years who were followed between 1985 and 2005.
  
  
  RESULTS
  The prevalence of GD was higher in females (3:1) and during puberty (for both genders). If no remission was detected during ATD treatment, RAI was indicated when the following criteria were present: non-compliance, relapse, or side effects that were related to ATDs, large goiter, and long-term use of ATDs. The majority of patients developed hypothyroidism within 6 months after RAI. A progressive higher dose regimen was implemented in the last 10 years of the study period. A second RAI dose was necessary in eight cases. During the follow-up period, three pregnancies occurred. One patient with a thyroid nodule and benign cytology was detected.
  
  
  CONCLUSIONS
  RAI therapy is effective and safe in the treatment of GD in children and adolescents.
authors.affiliation: Endocrinology and Metabolism, Medicine Department Irmandade da Santa Casa de Misericórdia de São Paulo 01221-020, São Paulo Brazil.
authors.forename: Adriano N
authors.initials: AN
authors.lastname: Cury
authors.forename: Verônica T
authors.initials: VT
authors.lastname: Meira
authors.forename: Osmar
authors.initials: O
authors.lastname: Monte
authors.forename: Marília
authors.initials: M
authors.lastname: Marone
authors.forename: Nilza M
authors.initials: NM
authors.lastname: Scalissi
authors.forename: Cristiane
authors.initials: C
authors.lastname: Kochi
authors.forename: Luís E P
authors.initials: LE
authors.lastname: Calliari
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Longui