Treatment of juvenile thyrotoxicosis: A review with emphasis on radioiodine treatment

Abstract

Objective: The aim of the present study was to evaluate the utility of radioiodine treatment for thyrotoxicosis in childhood and adolescence and to evaluate its outcomes. Methods: This was a retrospective monocentric study of 15 patients (ages 7- 18 years) with a diagnosis of thyrotoxicosis who received iodine-131 (I-131) treatment from January 2015 to July 2019 in the Nuclear Medicine department of King Fahd Medical city. Age, gender, duration of antithyroid drug (ATD) treatment, thyroid uptake, total dose and number of treatments with I-131, and thyroid status at 6 months after treatment were recorded. Results: The outcomes of 15 patients (100% female) treated with radioactive iodine were analyzed to assess the effectiveness of therapy by iodine 131. All children and adolescents underwent 99m technetium thyroid scan with uptake before the procedure. There was no pre-existing ophthalmopathy. Thyroid uptake value was calculated using Sodium Pertechnetate. The average of the treatment activity of iodine 131was 340.4 MBq (247.9-555). There was no vomiting in all cases. Six 6 months after treatment, 7/15 were euthyroid, and 8/15 were hypothyroid. There was no hyperthyroid. All the patients received single radioiodine treatment. Conclusions: Radioiodine treatment is safe and effective for thyrotoxicosis in childhood and adolescence. The results of this present study support the use of radio dine 131 in treating hyperthyroidism in this particular population. It is suitable as a good Second-line therapy for patients who fail to respond to ATD treatment. Although special treatment precautions may be required in this age group, the ease of administration, effectiveness and safety of radio dine 131 continue to make it more and more attractive for initial treatmentof hyperthyroidism, especially when the appropriate treatment activity is prescribed.