Article detail · 2018
Management of thyrotoxicosis in children and adolescence: a Turkish multi-center experience
Journal of Clinical Research in Pediatric Endocrinology
- Year
- 2018
- ISSN
1308-5727- Type
- article
Data source split
- YÖKSİS YÖKSİS article record
- OpenAlex OpenAlex enrichment (abstract, citations, topics)
Abstract
English (OpenAlex)
Objective: To determine demographic and biochemical features of childhood and juvenile thyrotoxicosis and determine the treatment outcomes in them.Methods: We reviewed records of 503 children from in 12 different cities of Turkey who were diagnosed with thyrotoxicosis between 2007 to 2017.Results: In all, 375 (74.6%) patients had been diagnosed with Graves' disease (GD) and 75 (14.9%)had hashitoxicosis, and 53 (10.5%) had been diagnosed with uncommon causes of thyrotoxicosis.Commonest presenting features in children with GD or hashitoxicosis were tachycardia and/or palpitation, weight loss and excessive sweating.The cumulative remission rate was 17.6% in 370 patients with GD who received ATDs for initial treatment, and were treated for a median of 22.8 months (range 0.3 -127 months).No variables predictive of the achievement of remission were identified.Twenty-seven patients with GD received secondline treatment for poor disease control and adverse events associated with antithyroid drugs.Total thyroidectomy was reported in 17 patients with no recurrence of thyrotoxicosis and all became hypothyroid.Ten patients received radioiodine; six became hypothyroid, 1 remained hyperthyroid and started taking antithyroid drug again; 1 achieved remission and 2 unknown progresses due to lost up follow up.Conclusion: This study demonstrated that using anti-thyroid drugs with the hope that the patients will enter a remission over time is generally accepted first-line approach in Turkish children and adolescents with GD, however, this approach achieved low remission rate which was consistent with previous studies What is already known on this topic? Graves' disease is the most common cause of the thyrotoxicosis in children and adolescents as in adults.Management of thyrotoxicosis in children and adolescents is controversial and often unsatisfactory. There is no data on clinical features and treatment outcomes of Turkish children and adolescents with thyrotoxicosis. What this study adds? Using anti-thyroid drugs with the hope that the patients will enter a remission over time is generally accepted first-line approach in Turkey, however, this approach achieved low remission rate which was consistent with previous studies Surgery has been preferred more than radioactive iodine ablation for poor disease control and adverse events associated with antithyroid drugs in Turkish children and adolescents with Graves' disease. IntroductionsThyrotoxicosis is characterized by excess circulating thyroid hormones, irrespective of the source (1).Juvenile thyrotoxicosis can have various clinical manifestations.It may affect growth and development of children and may cause pronounced neuropsychological manifestations (2).Graves' disease (GD) is the most common cause for thyrotoxicosis in childhood (2).Incidence of GD increases with age accordingly it is less common in children than in adults.However, increasing incidence rate of GD in children have been reported by several studies (3-6).Although a few treatment guidelines have been published, its management is controversial and often unsatisfactory (7-9).Treatment options for thyrotoxicosis in children include antithyroid drugs (ATDs), radioactive iodine therapy (RI), and surgical interventions.Most
Topics
- Thyroid Disorders and Treatments
Primary topic Thyroid Disorders and Treatments