Long-term outcome of thyrotoxicosis in childhood and adolescence in the west of Scotland: the case for long-term antithyroid treatment and the importance of initial counselling

Abstract

Management of thyrotoxicosis in children and adolescents remains challenging and treatment varies considerably among institutions. The patient’s age, clinical status and likelihood of remission should be considered when counseling patients and parents. Nevertheless, individual prognosis of antithyroid drug treated Graves’ disease in children is highly variable and studies with data on long-term outcome are scarce. Recommendation 58 of the 2016 American Thyroid Association guidelines state that children with Graves’ disease can be treated with either methimazole or thyroidectomy at any age. Alternatively, radioiodine ablation is a further option, but not before 5 years of age, and between 5-10 years only if radioiodine activity is <10mCi.