title: Graves' disease in children.
abstract: Graves' disease is an autoimmune disorder resulting from thyrotropin receptor stimulation by autoantibodies. It may occur at any age during childhood, but its frequency increases with age, peaking during adolescence. Symptoms and signs are often recognizable and proportional to the increase in serum free thyroid hormone levels. Antithyroid drug treatment with methimazole (or carbimazole) is recommended for initial treatment, but relapse rates are high, with remission achieved in only 30% of children after a first course of treatment for about two years. More prolonged medical treatment may increase the remission rate to up to 50%. Alternative treatments, such as radioactive iodine or thyroidectomy, are considered in cases of relapse, lack of compliance or antithyroid drug toxicity. Relapse risk decreases with increasing duration of the first course of antithyroid drug treatment. The identification of other predictive factors, such as severe biochemical hyperthyroidism at diagnosis, young age and the absence of other autoimmune conditions, has made it possible to stratify patients according to the risk of relapse, leading to improvements in patient management, by facilitating the identification of patients requiring long-term antithyroid drug treatment or early alternative therapy.
authors.affiliation: Univ Paris Diderot, Sorbonne Paris Cité, F-75019 Paris, France; AP-HP, Hôpital Robert Debré, Service d'Endocrinologie Diabétologie Pédiatrique et Centre de Référence des Maladies Endocriniennes Rares de la Croissance, F-75019 Paris, France; Institut National de la Santé et de la Recherche Médicale, UMR 676, F-75019 Paris, France. Electronic address: juliane.leger@rdb.aphp.fr.
authors.forename: Juliane
authors.initials: J
authors.lastname: Léger
authors.affiliation: Univ Paris Diderot, Sorbonne Paris Cité, F-75019 Paris, France; AP-HP, Hopital Robert Debré, Unité de Pharmacologie Pédiatrique, INSERM CIC9202, 75019 Paris, France.
authors.forename: Florentia
authors.initials: F
authors.lastname: Kaguelidou
authors.affiliation: Univ Paris Diderot, Sorbonne Paris Cité, F-75019 Paris, France; AP-HP, Hopital Robert Debré, Unité d'Epidémiologie Clinique, INSERM CIC-EC CIE5, 75019 Paris, France.
authors.forename: Corinne
authors.initials: C
authors.lastname: Alberti
authors.affiliation: Univ Paris Diderot, Sorbonne Paris Cité, F-75019 Paris, France; AP-HP, Hôpital Robert Debré, Service d'Endocrinologie Diabétologie Pédiatrique et Centre de Référence des Maladies Endocriniennes Rares de la Croissance, F-75019 Paris, France; Institut National de la Santé et de la Recherche Médicale, UMR 676, F-75019 Paris, France.
authors.forename: Jean Claude
authors.initials: JC
authors.lastname: Carel
mesh_terms: D000293:Adolescent; D013956:Antithyroid Agents / Q000627:therapeutic use; D001323:Autoantibodies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006111:Graves Disease / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D010349:Patient Compliance; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000276:immunology; D014463:Ultrasonography
chemical_list: D013956:Antithyroid Agents; D001323:Autoantibodies
keywords: Graves' disease; childhood; hyperthyroidism