MANAGEMENT OF HYPERTHYROIDISM IN CHILDREN AND ADOLESCENTS – TEN YEARS EXPERIENCE
Background. Graves disease is the most common cause of hyperthyrosis in children and adolescents. The optimal treatment for children with AH remains controversial. The patients are usually treated with antithyroid drugs in combination with thyroxine, followed by definitive treatment with either surgery or radio-iodine if stable remission with antithyroid drug can not be achieved.
Patients and methods. Between 1991 and 2000, 45 children (41 girls) from 0.5 to 17.5 years were treated at the University Childrens Hospital Ljubljana.
Results and conclusions. Fourteen (31.1%) patients achieved long-term remission with antithyroid drugs alone. 12 (26.7%) of children needed further therapy. Surgery was carried out in 6 (50%), ablation therapy with J131 was successfully used in other six patients.
Di George AM. Hyperthyroidism. In: Behrman RE, Kliegman RM, Jenson HB eds. Nelson Textbook of pediatrics. Philadelphia: Saunders, 2000: 1709–12.
Zimmermann K, Gan-Gaisano M. Hyperthyroidism in children and adolescents. Pediatr Clin North Am 1990; 37: 1273–3.
Kraiem Z, Newfield RS. Graves’ disease in childhood. Pediatr Endocrinol Metab 2001; 14: 229–43.
Kappy MS, Blizzard R, Migeon CJ. In: Folly T, Malvaux P, Blizzard R eds. Thyroid diseases. The diagnosis and treatment of endocrine disorders in childhood and adolescence. 4th ed. Chicago: Wilkins, 1994: 493–503.
Raza J, Hindmarsh PC, Brook CGD. Thyrotoxicosis in children: thirty years experience. Acta Pediatr 1999; 88: 937–41.
Perrild H, Grüters-Kieslich A, Feldt-Rasmussen U et al. Diagnosis and treatment of thyrotoxicosis in childhood. A European questionnaire study. Eur J Endocrinol 1994; 131: 467–73.
Vanderpump MJP, Ahlquist JAO, Franklin JA, Clayton RN. Consensus treatment for good practise and audit measures in the management of hypothyroidism and hyperthyroidism. Br Med J 1996; 313: 539–44.
Rittmaster RS, Abbot EC, Douglas R, Givner ML et al. Effect of methimazole, with or without L-thyroxine, on remission rates in Grave’s disease. J Clin Endocrin Metab 1998; 83: 814–8.
Barnes HV, Blizzard RM. Antithyroid drug therapy for toxic diffuse goiter: thirty years of experience in children and adolescents. J Pediatr 1977; 91: 313–20.
Lippe BM, Landaw EM, Kaplan SA. Hyperthyroidism in children treated with long-term medical therapy: twenty-five percent remission every two years. J Clin Endocrinol Metab 1987; 64: 1241–5.
Zimmermann D, Lteif AN. Thyrotoxicosis in children. Endocrinol Metab North Am 1998; 27: 109–26.
Hamburger JI. Management of hyperthyroidism in children and adolescents. J Clin Endocrinol Metab 1985; 60: 1019–24.
Buchingam BA, Costin G, Roe TF, Weitzman JJ, Kogut NN. Hyperthyroidism in children. A re-evaluation of treatment. Am J Dis Child 1981; 135: 112–7.
Wilson R, Buchanan L, Fraser WD, Mckillop JH, Thomson JA. Do higher doses of carbimazole improve remission in Graves’ disease? QJ Med 1996; 89: 381–5.
Rivkees SA, Sklar C, Freemark M. The management of Graves’ disease in children, with special emphasis on radioiodin treatment. J Clin Endocrinol Metab 1998; 83: 3767–76.
Söreide J, Heerden JA, Lo CY, Grant CS, Zimmermann D, Ilstrup DM. Surgical treatment of Graves’ disease in patients younger than 18 years. World J Surg 1996; 20: 794–800.
Cheetham TD, Wraight P, Hughes IA, Barnes ND. Radioiodine treatment of Graves’ disease in young people. Horm Res 1998; 49: 258–62.
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