Pediatric Graves' disease:: Outcome and treatment

Graves' disease treatment in children and adolescents includes antithyroid drugs (ATD), I-131 (RI) or subtotal thyroidectomy (CX), all of which present beneficial effects and disadvantages. Objective: To review our experience in the management of pediatric patients with Graves' disease considering the therapeutic strategies used. Patients and Methods: Clinical and biochemical data of 116 children (23 boys) aged 11.2 +/- 3.7 years at diagnosis were reviewed. Outcome and remission were evaluated and persistency at 10 years calculated with Kaplan Meier analysis. Results: Initially 113/116 patients received ATD, two RI and one CX After 10 years of follow up, 38 remitted with ATD, D were persistently hyperthyroid with ATD, 38 received RI, one underwent CX, and 13 were lost to follow up. The cumulative proportion with persistent hyperthyroidism at 10 years was 31%. Conclusions: ATD, although the first choice of treatment, was long-lasting and achieved a low remission rate at 10 years of follow up. Conversely, RI was shown to be a safe, low cost, efficient and definitive alternative for Graves' disease treatment in children and adolescents.