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Pediatric Graves' disease: decisions regarding therapy
Erin R Okawa1, Frederick D Grant, Jessica R Smith
1aDivision of Endocrinology, Department of Medicine bDivision of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA.
Current Opinion in Pediatrics
|June 19, 2015
Summary
Graves' disease, a common cause of pediatric hyperthyroidism, often presents severely in younger children. While remission rates are low, radioactive iodine ablation is a viable permanent treatment option.
Area of Science:
- Pediatric Endocrinology
- Autoimmune Diseases
Background:
- Graves' disease is the leading cause of hyperthyroidism in children and adolescents.
- Prepubertal children often experience more severe disease and lower remission rates compared to pubertal children.
Purpose of the Study:
- To review current diagnostic and treatment modalities for pediatric Graves' disease.
- To address the controversy surrounding permanent therapeutic options.
Main Methods:
- Clinical diagnosis supported by advanced thyroid-stimulating hormone receptor antibody assays.
- Ongoing research into autoimmune processes and genetic factors.
Main Results:
- Remission rates for Graves' disease in pediatric populations remain low.
- There is an increasing trend towards permanent therapy, particularly radioactive iodine ablation, when medical therapy fails.
Conclusions:
- Identification of new genes and susceptibility loci may improve understanding of Graves' disease.
- Radioactive iodine ablation is a recommended permanent treatment option given low remission rates.
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