Time course to hypothyroidism after fixed-dose radioablation therapy of Graves' disease in children
Abstract
Objective To characterize the development of hypothyroidism in pediatric patients who receive a fixed dose of radioactive iodine (RAI).Study design Medical records of children treated with fixed-dose RAI for Graves'disease between 1993 and 2001 were reviewed. Multiple variables including sex, age, thyroid hormone levels, thyroid-stimulating immunoglobulin titer, antithyroid medication use, and 24-hour radioiodine uptake were investigated as possible predictive factors for the development of hypothyroidism after treatment. All patients received RAI at a dose of between 13.8 and 15.6 mCi (average, 14.7 mCi; SD, 0.5).Results Permanent hypothyroidism developed in all 40 patients, although a second dose of RAI was required in one case. The average time to hypothyroidism was 77 days (SD, 32), with a range of 28 to 194 days; 75% of the patients were diagnosed with hypothyroidism between 40 and 90 days. RAI treatment was ineffective in an additional patient, who required subtotal thyroidectomy.Conclusions We conclude that a fixed dose of RAI is effective therapy in nearly all pediatric patients with Graves'disease. Factors predicting the time course to hypothyroidism were not identified.
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Hypothyroidism typically develops by 2-3 months posttreatment.
“Hypothyroidism typically develops by 2-3 months posttreatment (333,349,350), at which time levothyroxine should be prescribed.”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [350]
Physicians at some centers administer a fixed dose of about 15 mCi RAI to all children, whereas others calculate the activity from estimation or direct measurement of gland size and 123I uptake.
“Physicians at some centers administer a fixed dose of about 15 mCi RAI to all children (350), whereas others calculate the activity from estimation or direct measurement of gland size and 123 I uptake (349).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [350]
Some physicians restart ATDs after treatment with RAI, but this practice is seldom required in children.
“Although some physicians restart ATDs after treatment with RAI (80), this practice is seldom required in children (309,310,350).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [350]
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- Authors
- Nebesio, T. D., Siddiqui, A. R., Pescovitz, O. H., & Eugster, E. A.
- Affiliations
- Riley Hospital for Children (US)
- Venue
- The Journal of Pediatrics
- Publisher
- Elsevier BV
- Published
- 2002-07
- Volume
- 141
- Issue
- 1
- Pages
- 99-103
- ISSN
- 0022-3476 (ISSN-L)
- OpenAlex
- W1966820180
- Cited by
- 66
- References
- 44
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2022: 1 · 2021: 4 · 2020: 2 · 2019: 2 · 2018: 2 · 2017: 1 · 2016: 2 · 2015: 4 · 2014: 4 · 2013: 3 · 2012: 5
- FWCI
- 1.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Pathology and Forensic Medicine › Ophthalmology and Eye Disorders
- Keywords
- Graves' disease, hypothyroidism, radioiodine ablation, pediatric patients, thyroid-stimulating antibodies, radioiodine uptake, subtotal thyroidectomy, treatment efficacy
- MeSH terms
- Adolescent, Child, Child, Preschool, Female, Graves Disease, Humans, Hypothyroidism, Indiana, Iodine Radioisotopes, Male, Radiotherapy Dosage, Retrospective Studies, Time Factors, Statistics, Nonparametric
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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