Long-Term Antithyroid Drug Treatment of Graves’ Disease in Children and Adolescents: A 20-Year Single-Center Experience
Background/purposeGraves’ disease (GD) is the most common cause of thyrotoxicosis in children and adolescents. There is some debate regarding the optimal treatment and predicting factors of remission or relapse in children and adolescents with GD. In this study, we report a retrospective study of 19...
Main Authors: | , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Frontiers Media S.A.
2021-06-01
|
Series: | Frontiers in Endocrinology |
Subjects: | |
Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2021.687834/full |
id |
doaj-50c9b14f435c491eba866b534645c2b1 |
---|---|
record_format |
Article |
spelling |
doaj-50c9b14f435c491eba866b534645c2b12021-06-14T11:17:42ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922021-06-011210.3389/fendo.2021.687834687834Long-Term Antithyroid Drug Treatment of Graves’ Disease in Children and Adolescents: A 20-Year Single-Center ExperienceAri Song0Su Jin Kim1Min-Sun Kim2Jiyeon Kim3Insung Kim4Ga Young Bae5Eunseop Seo6Young Seok Cho7Joon Young Choi8Sung Yoon Cho9Dong-Kyu Jin10Department of Pediatrics, Incheon Sejong Hospital, Incheon, South KoreaDepartment of Pediatrics, Inha University Hospital, Inha University College of Medicine, Incheon, South KoreaDepartment of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South KoreaDepartment of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South KoreaDepartment of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South KoreaDepartment of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South KoreaDepartment of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South KoreaDepartment of Nuclear Medicine and Molecular Imaging, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South KoreaDepartment of Nuclear Medicine and Molecular Imaging, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South KoreaDepartment of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South KoreaDepartment of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South KoreaBackground/purposeGraves’ disease (GD) is the most common cause of thyrotoxicosis in children and adolescents. There is some debate regarding the optimal treatment and predicting factors of remission or relapse in children and adolescents with GD. In this study, we report a retrospective study of 195 children and adolescents with GD treated at a single tertiary institution in Korea.MethodsThis study included children and adolescents with GD diagnosed before 19 years of age from January of 2000 to October of 2020. The diagnosis of GD was based on clinical features, high thyroxine (FT4), suppressed thyroid-stimulating hormone, and a positive titer of thyrotropin receptor antibodies. Remission was defined as maintenance of euthyroid status for more than six months after discontinuing antithyroid drug (ATD).ResultsA total of 195 patients with GD were included in this study. The mean age at diagnosis was 12.9 ± 3.2 years, and 162 patients (83.1%) were female. Among all 195 patients, five underwent thyroidectomy and three underwent radioactive iodine therapy. The mean duration of follow-up and ATD treatment were 5.9 ± 3.8 years and 4.7 ± 3.4 years, respectively. The cumulative remission rates were 3.3%, 19.6%, 34.1%, 43.5%, and 50.6% within 1, 3, 5, 7, and 10 years of starting ATD, respectively. FT4 level at diagnosis (P = 0.001) was predicting factors for remission [HR, 0.717 (95% CI, 0.591 – 0.870), P = 0.001]. Methimazole (MMI)-related adverse events (AEs) occurred in 11.3% of patients, the most common of which were rash and hematologic abnormalities. Of a total of 26 AEs, 19 (73.1%) occurred within the first month of taking MMI.ConclusionsIn this study, the cumulative remission rate increased according to the ATD treatment duration. Long-term MMI treatment is a useful treatment option before definite treatment in children and adolescents with GD.https://www.frontiersin.org/articles/10.3389/fendo.2021.687834/fullGraves’ diseasehyperthyroidismantithyroid drugsremissionchildren |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ari Song Su Jin Kim Min-Sun Kim Jiyeon Kim Insung Kim Ga Young Bae Eunseop Seo Young Seok Cho Joon Young Choi Sung Yoon Cho Dong-Kyu Jin |
spellingShingle |
Ari Song Su Jin Kim Min-Sun Kim Jiyeon Kim Insung Kim Ga Young Bae Eunseop Seo Young Seok Cho Joon Young Choi Sung Yoon Cho Dong-Kyu Jin Long-Term Antithyroid Drug Treatment of Graves’ Disease in Children and Adolescents: A 20-Year Single-Center Experience Frontiers in Endocrinology Graves’ disease hyperthyroidism antithyroid drugs remission children |
author_facet |
Ari Song Su Jin Kim Min-Sun Kim Jiyeon Kim Insung Kim Ga Young Bae Eunseop Seo Young Seok Cho Joon Young Choi Sung Yoon Cho Dong-Kyu Jin |
author_sort |
Ari Song |
title |
Long-Term Antithyroid Drug Treatment of Graves’ Disease in Children and Adolescents: A 20-Year Single-Center Experience |
title_short |
Long-Term Antithyroid Drug Treatment of Graves’ Disease in Children and Adolescents: A 20-Year Single-Center Experience |
title_full |
Long-Term Antithyroid Drug Treatment of Graves’ Disease in Children and Adolescents: A 20-Year Single-Center Experience |
title_fullStr |
Long-Term Antithyroid Drug Treatment of Graves’ Disease in Children and Adolescents: A 20-Year Single-Center Experience |
title_full_unstemmed |
Long-Term Antithyroid Drug Treatment of Graves’ Disease in Children and Adolescents: A 20-Year Single-Center Experience |
title_sort |
long-term antithyroid drug treatment of graves’ disease in children and adolescents: a 20-year single-center experience |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Endocrinology |
issn |
1664-2392 |
publishDate |
2021-06-01 |
description |
Background/purposeGraves’ disease (GD) is the most common cause of thyrotoxicosis in children and adolescents. There is some debate regarding the optimal treatment and predicting factors of remission or relapse in children and adolescents with GD. In this study, we report a retrospective study of 195 children and adolescents with GD treated at a single tertiary institution in Korea.MethodsThis study included children and adolescents with GD diagnosed before 19 years of age from January of 2000 to October of 2020. The diagnosis of GD was based on clinical features, high thyroxine (FT4), suppressed thyroid-stimulating hormone, and a positive titer of thyrotropin receptor antibodies. Remission was defined as maintenance of euthyroid status for more than six months after discontinuing antithyroid drug (ATD).ResultsA total of 195 patients with GD were included in this study. The mean age at diagnosis was 12.9 ± 3.2 years, and 162 patients (83.1%) were female. Among all 195 patients, five underwent thyroidectomy and three underwent radioactive iodine therapy. The mean duration of follow-up and ATD treatment were 5.9 ± 3.8 years and 4.7 ± 3.4 years, respectively. The cumulative remission rates were 3.3%, 19.6%, 34.1%, 43.5%, and 50.6% within 1, 3, 5, 7, and 10 years of starting ATD, respectively. FT4 level at diagnosis (P = 0.001) was predicting factors for remission [HR, 0.717 (95% CI, 0.591 – 0.870), P = 0.001]. Methimazole (MMI)-related adverse events (AEs) occurred in 11.3% of patients, the most common of which were rash and hematologic abnormalities. Of a total of 26 AEs, 19 (73.1%) occurred within the first month of taking MMI.ConclusionsIn this study, the cumulative remission rate increased according to the ATD treatment duration. Long-term MMI treatment is a useful treatment option before definite treatment in children and adolescents with GD. |
topic |
Graves’ disease hyperthyroidism antithyroid drugs remission children |
url |
https://www.frontiersin.org/articles/10.3389/fendo.2021.687834/full |
work_keys_str_mv |
AT arisong longtermantithyroiddrugtreatmentofgravesdiseaseinchildrenandadolescentsa20yearsinglecenterexperience AT sujinkim longtermantithyroiddrugtreatmentofgravesdiseaseinchildrenandadolescentsa20yearsinglecenterexperience AT minsunkim longtermantithyroiddrugtreatmentofgravesdiseaseinchildrenandadolescentsa20yearsinglecenterexperience AT jiyeonkim longtermantithyroiddrugtreatmentofgravesdiseaseinchildrenandadolescentsa20yearsinglecenterexperience AT insungkim longtermantithyroiddrugtreatmentofgravesdiseaseinchildrenandadolescentsa20yearsinglecenterexperience AT gayoungbae longtermantithyroiddrugtreatmentofgravesdiseaseinchildrenandadolescentsa20yearsinglecenterexperience AT eunseopseo longtermantithyroiddrugtreatmentofgravesdiseaseinchildrenandadolescentsa20yearsinglecenterexperience AT youngseokcho longtermantithyroiddrugtreatmentofgravesdiseaseinchildrenandadolescentsa20yearsinglecenterexperience AT joonyoungchoi longtermantithyroiddrugtreatmentofgravesdiseaseinchildrenandadolescentsa20yearsinglecenterexperience AT sungyooncho longtermantithyroiddrugtreatmentofgravesdiseaseinchildrenandadolescentsa20yearsinglecenterexperience AT dongkyujin longtermantithyroiddrugtreatmentofgravesdiseaseinchildrenandadolescentsa20yearsinglecenterexperience |
_version_ |
1721378465058390016 |