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Management of hyperthyroidism in children

Filippo De Luca1, Giuseppina Salzano1, Giuseppina Zirilli1

  • 1a Department of Human Pathology of Adulthood and Childhood , University of Messina , Messina , Italy.

Expert Review of Endocrinology & Metabolism
|July 31, 2018
PubMed

Insights

Treatment for pediatric hyperthyroidism, especially Graves' disease (GD), needs individualized approaches. While drug therapy is common, radical treatments may be suitable for relapsing cases in children.

Area of Science:

  • Pediatric Endocrinology
  • Thyroidology

Background:

  • Hyperthyroidism treatment in children lacks a universally adopted, evidence-based strategy, particularly for Graves' disease (GD).
  • Optimal therapeutic approaches for pediatric hyperthyroidism vary by etiology and require careful consideration.

Purpose of the Study:

  • To review recent treatment strategies for pediatric hyperthyroidism, focusing on Graves' disease.
  • To provide guidance for individualizing treatment in children with hyperthyroidism.

Main Methods:

  • Systematic literature search of PubMed and Cochrane databases (1990-2016).
  • Keywords included: Hyperthyroidism, Childhood, Antithyroid drug therapy, Thyroidectomy, Radioactive iodine.

Main Results:

  • Pharmacological therapy is the primary approach for pediatric GD.
  • Individualized treatment, considering radical options for frequent relapses, is recommended.
  • Criteria for individualized therapy and management of non-GD hyperthyroidism are discussed.

Conclusions:

  • An individualized therapeutic strategy is crucial for managing pediatric Graves' disease.
  • Treatment decisions should not exclude radical therapies when clinically indicated, especially in cases of frequent relapses.
Abstract

Keywords:
Fetal and neonatal hypothyroidismGraves’ diseaseHashitoxicosisMcCune Albright syndromeTSH-secreting pituitary adenomahyperfunctioning thyroid nodulesmethimazole treatmentradioiodine therapyresistance to thyroid hormonestotal thyroidectomy

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