Abstract
Background/aim Graves’ disease (GD) is more severe, requires a more complex treatment, and has a lower probability of achieving remission in children than in adults. There is no consensus on the appropriate duration of antithyroid drug (ATD) treatment. Surgical or radioactive iodine (RAI) treatments are not definitive and generally result in permanent hypothyroidism. This study’s goal was examining the effectiveness of ATD treatment in children and adolescents with GD and determining the risk factors of remission and relapse.Materials and methods This retrospective study included 45 patients (36 females and 9 males, median age 12.5 years) aged 4–18 who were diagnosed with GD between 2003 and 2017. All patients initially were treated with an ATD. ATD treatment was discontinued at a mean of 23.2 ± 13.2 months (10–37 months). Results Patients were classified into remission (n = 24) and relapse groups (n = 21). The duration of initial ATD treatment in the remission group was longer (26.91 ± 5.17 months) than in the relapse group (19.09 ± 7.14 months) (P = 0.01). The total ATD treatment duration was statistically longer in the remission group (42.14 ± 14.35 months) than in the relapse group (26.95 ± 16.13 months) (P = 0.03). Conclusion Long-term initial ATD treatment and long-term total ATD treatment were evaluated as positive parameters for the remission of Graves’ disease in children and adolescents. Our findings showed that the chance of long-term remission increases in direct proportion to the initial ATD treatment duration and the total ATD treatment duration.
Highlights
Graves’ disease (GD) is the most common cause of hyperthyroidism and constitutes 10%–15% of thyroid diseases in children
Long-term initial antithyroid drug (ATD) treatment and long-term total ATD treatment were evaluated as positive parameters for the remission of Graves’ disease in children and adolescents
Our findings showed that the chance of long-term remission increases in direct proportion to the initial ATD treatment duration and the total ATD treatment duration
Summary
Graves’ disease (GD) is the most common cause of hyperthyroidism and constitutes 10%–15% of thyroid diseases in children. The incidence of GD is about 1/10,000 in children and adolescents [1,2,3]. GD is more common in girls (F/M = 5/1) and peaks in adolescence at the age of 11–15 years [4]. The diagnosis is made with increased serum-free T3 (fT3) (2.6–4.8 pg/mL) and free T4 (fT4) (0.7–2 ng/dL) levels, suppressed serum TSH level (0.4–3.0 μIU/mL), positive thyroid receptor antibody (TRab) (
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