TITLE

Outcome of pediatric Graves' disease after treatment with antithyroid medication and radioiodine

AUTHOR(S)
Ward, Leanne; Huot, Celine
PUB. DATE
August 1999
SOURCE
Clinical & Investigative Medicine;Aug99, Vol. 22 Issue 4, p132
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Objective: To evaluate the efficacy of antithyroid medication in the initial treatment of pediatric Graves' disease and the frequency of use and outcome of radioiodine as second-line therapy. Design: Retrospective review. Setting: Tertiary care children's hospital. Patients: Thirty-three patients (29 female, 4 male; mean age 12.7 years) who started treatment for hyperthyroidism between Jan. 1, 1990, and Dec. 31, 1994. Interventions: Initial treatment with propylthiouracil or methimazole (with addition of levothyroxine if needed to maintain euthyroidism); subsequent treatment with radioiodine. Outcome measures: 1) Clinical and laboratory features at the time of diagnosis; 2) doses and duration of antithyroid drug treatment and response to treatment; 3) need for treatment with levothyroxine to maintain euthyroidism during the trial of antithyroid medication; 4) indications for radioiodine therapy, and the dose and number of treatments with 131iodine (131I); 5) thyroid status at last follow-up visit (at least 2 years after diagnosis). Results: All patients were initially treated with antithyroid drugs, and levothyroxine was added in 16 subjects to maintain euthyroidism. The median duration of drug treatment was 21 months. Ultimately, 24/33 patients (73%) received radioiodine following a trial of antithyroid drugs because of a) side effects of antithyroid medication (in 3 patients); b) inadequate response to medication (in 8 patients); and c) relapse (in 13 patients), which occurred at a median of 6 (range 1 to 16) months following cessation of drug therapy. Five patients required a second dose of radioiodine and 2 patients required 3 doses. Of the 24 patients treated with radioiodine, at last follow-up after the most recent treatment (median 18.5, range 3 to 55 months), 6 patients were euthyroid, 16 required thyroxine replacement, and 2 were still, or again, hyperthyroid. Conclusion: In our population of children and adolescents, treatment of hyperthyroidism with...
ACCESSION #
2264440

 

Related Articles

  • Determination of the optimal minimum radioiodine dose in patients with Graves' disease: a clinical outcome study. Howarth, Douglas; Epstein, Martin; Lan, Linda; Tan, Phillip; Booker, John // European Journal of Nuclear Medicine;2001, Vol. 28 Issue 10, p1489 

    The study was performed under the auspices of the International Atomic Energy Commission, Vienna, Austria, with the aim of determining the optimal minimum therapeutic dose of iodine-131 for Graves' disease. The study was designed as a single-blinded randomised prospective outcome trial....

  • Trends in treatments of thyroid disease following iodine fortification in Denmark: a nationwide register-based study. Møllehave, Line Tang; Linneberg, Allan; Skaaby, Tea; Knudsen, Nils; Jørgensen, Torben; Thuesen, Betina Heinsbæk // Clinical Epidemiology;Jul2018, Vol. 10, p763 

    Background: Long-term iodine exposure may influence the frequency of thyroid disease treatments through fluctuations in thyroid diseases. Yet, the long-term fluctuations in thyroid disease treatments upon iodine fortification (IF) are not fully known. We aimed to examine the development in...

  • Successful radioiodine treatment in a 3 year old child with Graves' disease following antithyroid medication induced neutropenia. Rahman, M.A.S.; Birrell, G.; Stewart, H.; Lucraft, H.; Cheetham, T.D. // Archives of Disease in Childhood;Feb2003, Vol. 88 Issue 2, p158 

    Focuses on the radioiodine treatment of a three-year old child with Graves' disease and mitral valve prolapse. Antithyroid medication-induced neutropenia; Echocardiogram prior to treatment; Management of thyrotoxicosis in childhood.

  • Thyroid surgery for Graves' disease. Toft, Anthony D. // British Medical Journal (Clinical Research Edition);3/5/1983, Vol. 286 Issue 6367, p740 

    Focuses on the effectiveness of thyroid surgery for graves' disease in Great Britain. Characterization of the disease; Use of radioactive iodine in patients of reproductive age; Incidence of postoperative hypothyroidism.

  • Radioiodine Therapy for Multinodular Goiter. Apgar, Barbara // American Family Physician;12/1/1999, Vol. 60 Issue 9, p2680 

    Presents an abstract of the study `Radioiodine Therapy for Multinodular Toxic Goiter,' by B. Nygaard et al., which appeared on the June 28, 1999 issue of the `Archives of Internal Medicine.'

  • MEDFAQs.  // Undersea & Hyperbaric Medicine;2017, Vol. 44 Issue 3, p297 

    The article presents questions and answers related to Hyperbaric Oxygen (HBO) treatment including studying the complications of EnzaRadicate, use of the radioisotope Iodine-125, and clinical screening tests recommended before treating patients with HBO2.

  • Are antithyroid drugs immunosuppressive? Kendall-Taylor, P. // British Medical Journal (Clinical Research Edition);2/18/1984, Vol. 288 Issue 6416, p509 

    Examines the mechanism of action of antithyroid drugs in Graves' disease. Suppression of the production of pathogenic antibodies; Inhibition of iodine organification; Components of antithyroid drugs.

  • Endocrinology & metabolism.  // Clinical & Investigative Medicine;Aug97 Supplement, Vol. 20, pS17 

    Presents an abstract of the research manuscript `Hyperthyroidism in children and adolescents: Should radioiodine be the first line therapy?,' by L. Ward, C. Huot et al from the Universite de Montreal.

  • The impact of the extent of thyroid resection complemented by radioiodine management on disease free status and discharge rates among differentiated thyroid cancer patients: A retrospective analysis. Nyathi, Mpumelelo; Mahlangu, Nyebe Phineas // Australasian Medical Journal;2018, Vol. 11 Issue 5, p305 

    Background: Well-differentiated thyroid cancers (DTC) are common endocrine cancers. They originate from follicular cells and parafollicular cells, and they have good prognosis. The pivotal treatment is surgery followed by radioiodine management. However, the extent of thyroid resection remains...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics