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Thyrotoxicosis in children: thirty years' experience
J Raza1, P C Hindmarsh, C G Brook
1London Centre for Paediatric Endocrinology, Great Ormond Street Hospital, United Kingdom.
Acta Paediatrica (Oslo, Norway : 1992)
|October 16, 1999
Summary
Antithyroid drugs (ATD) are the preferred first-line treatment for pediatric thyrotoxicosis, with block-replacement regimens offering greater convenience. Surgery is safe in specialized centers, but radioactive iodine (I131) use requires caution in young children.
Area of Science:
- Pediatric Endocrinology
- Thyroid Disorders
- Internal Medicine
Background:
- Optimal management of pediatric thyrotoxicosis is debated.
- Antithyroid drug (ATD) therapy is a common treatment modality.
Purpose of the Study:
- To review management practices and outcomes for pediatric thyrotoxicosis.
- To evaluate the effectiveness of different therapeutic interventions.
Main Methods:
- Retrospective review of 76 pediatric patients treated between 1965 and 1995.
- Analysis of antithyroid drug (ATD) therapy, surgery, and radioactive iodine (I131) outcomes.
Main Results:
- Long-term remission achieved in 38% of patients on ATD alone after a mean of 3.3 years.
- Block-replacement ATD regimens were significantly more convenient than titration (3.4 vs. 6.1 hospital visits/year).
- Surgery resulted in hypothyroidism in 24 of 27 patients; I131 was successful in six patients.
Conclusions:
- Antithyroid drug (ATD) therapy should remain the first-line treatment for pediatric thyrotoxicosis.
- Block-replacement regimens offer improved convenience for ATD therapy.
- Surgery in specialized centers is low-risk, and I131 use requires caution in young children.