Treatment of childhood Graves' disease: A review with emphasis on radioiodine treatment
Abstract
Graves’ disease is the most common form of hyperthyroidism in children. Because of complications with either thyroid surgery or antithyroid drug therapy, the authors prefer high-dose radioiodine as the initial treatment of choice. Long-term follow-up studies have not shown an increased incidence of malignancy in the patients or birth defects in their offspring.
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Properly administered, RAI is an effective treatment for GD in the pediatric population.
“Properly administered, RAI is an effective treatment for GD in the pediatric population (308)(309)(310).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [310]
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 [310]
Fewer than 10% of children complain of mild tenderness over the thyroid in the first week after therapy; it can be treated effectively with acetaminophen or nonsteroidal anti-inflammatory agents for 24-48 hours.
“Fewer than 10% of children complain of mild tenderness over the thyroid in the first week after therapy; it can be treated effectively with acetaminophen or nonsteroidal anti-inflammatory agents for 24-48 hours (310,349).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [310]
Cited by
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Ross, D. S., Burch, H. B., Cooper, D. S., Greenlee, M. C., Laurberg, P., Maia, A. L., Rivkees, S. A., Samuels, M., Sosa, J. A., Stan, M. N., et al. (2016) · Thyroid® · doi:10.1089/thy.2016.0229 · Cited by 2,938 · see citing works
“Fewer than 10% of children complain of mild tenderness over the thyroid in the first week after therapy; it can be treated effectively with acetaminophen or nonsteroidal anti-inflammatory agents for 24–48 hours (310,349).”
BackgroundBahn, R. S., Burch, H. B., Cooper, D. S., Garber, J. R., Greenlee, M. C., Klein, I., Laurberg, P., McDougall, I. R., Montori, V. M., Rivkees, S. A., et al. (2011) · Endocrine Practice · doi:10.4158/ep.17.3.456 · Cited by 1,098 · see citing works
“Less than 10% of children complain of mild tenderness over the thyroid in the first week after therapy; it can be treated effectively with acetaminophen or nonsteroidal anti-inflammatory agents for 24–48 hours (189,224).”
BackgroundThe American Thyroid Association and American Association of Clinical Endocrinologists Taskforce on Hyperthyroidism and Other Causes of Thyrotoxicosis, Bahn, R. S., Burch, H. B., Cooper, D. S., Garber, J. R., Greenlee, M. C., Klein, I., Laurberg, P., McDougall, I. R., Montori, V. M., et al. (2011) · Thyroid · doi:10.1089/thy.2010.0417 · Cited by 898 · see citing works
“Although some physicians restart ATDs after treatment with (131)I (225), this practice is seldom required in children (188,189,224,226).”
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“Less than 10 % of children will complain of mild tenderness over the thyroid in the first week after (131)I therapy [70, 71].”
BackgroundTime course to hypothyroidism after fixed-dose radioablation therapy of Graves' disease in children
Nebesio, T. D., Siddiqui, A. R., Pescovitz, O. H., & Eugster, E. A. (2002) · The Journal of Pediatrics · doi:10.1067/mpd.2002.125494 · Cited by 66 · see citing works
Guidelines for the treatment of childhood-onset Graves’ disease in Japan, 2016
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Hyperthyroidism in Children and Adolescents
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“It is recommended that these patients receive a second dose of radioiodine [62], which can be given 6 months after initial therapy.”
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tsch, J. D., Rascher, W., & rr, H. G. D. (2003) · Pediatric Drugs · doi:10.2165/00128072-200305020-00003 · Cited by 35 · see citing works
“[43] If a lower dose of 50–100 μCi is used, long-term outcome, with regard to cure from hyperthyroidism, is far less.”
BackgroundSurgical Treatment of Graves’ Disease in Patients Younger than 18 Years
Søreide, J. A., van Heerden, J. A., Lo, C., Grant, C. S., Zimmerman, D., & Ilstrup, D. M. (1996) · World Journal of Surgery · doi:10.1007/s002689900121 · Cited by 30 · see citing works
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“Treatments available for GD include anti-thyroid medications (methimazole or propylthiouracil), surgery and radioactive iodine (RAI) [4,5].”
BackgroundCury, A. N., Meira, V. T., Monte, O., Marone, M. M. S., Scalissi, N. M., Kochi, C., Calliari, L. E., & Longui, C. A. (2012) · Endocrine Connections · doi:10.1530/ec-12-0049 · Cited by 21 · see citing works
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“They also recommended a treatment dose of 300 µCi/g to insure the hypothyroid state (9).”
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BackgroundShould radioiodine be the first-line treatment for paediatric Graves’ disease?
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- Authors
- LEVY, W. J., SCHUMACHER, O. P., & GUPTA, M.
- Venue
- Cleveland Clinic Journal of Medicine
- Publisher
- Cleveland Clinic Journal of Medicine
- Published
- 1988-07-01
- Volume
- 55
- Issue
- 4
- Pages
- 373-382
- ISSN
- 0891-1150 (ISSN-L)
- 1939-2869
- OpenAlex
- W2328100076
- Cited by
- 60
- References
- 0
- Citations by year
- 2024: 1 · 2022: 1 · 2021: 1 · 2020: 2 · 2018: 2 · 2017: 1 · 2016: 3 · 2015: 4 · 2014: 4 · 2013: 2 · 2012: 3
- FWCI
- 1.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Cleveland Clinic Journal of Medicine (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, childhood hyperthyroidism, radioiodine therapy, antithyroid drugs, thyroid surgery, cancer risk, congenital malformations, long-term follow-up
- MeSH terms
- Child, Combined Modality Therapy, Graves Disease, Humans, Infant, Newborn, Iodine Radioisotopes, Radiotherapy Dosage, Antithyroid Agents, Thyroidectomy
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