Evaluation of Clinical Characteristics and Treatment Outcomes of Graves Disease in Children and Adolescents

Objective: The most common cause of hyperthyroidism in childhood and adolescence is Graves’ disease. In this study, we aimed to evaluate the demographic characteristics, clinical and laboratory findings, treatment processes, and remission outcomes in patients followed up with the diagnosis of Grave...

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Main Authors: Alev Aldemir Sönmez, Ibrahim Mert Erbas, Sezer Acar, Korcan Demir, Ece Bober, Ayhan Abaci
Format: Article
Language:English
Published: Aydın Pediatric Society 2021-03-01
Series:Trends in Pediatrics
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Online Access:https://trendspediatrics.com/article/view/18
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author Alev Aldemir Sönmez
Ibrahim Mert Erbas
Sezer Acar
Korcan Demir
Ece Bober
Ayhan Abaci
author_facet Alev Aldemir Sönmez
Ibrahim Mert Erbas
Sezer Acar
Korcan Demir
Ece Bober
Ayhan Abaci
author_sort Alev Aldemir Sönmez
collection DOAJ
description Objective: The most common cause of hyperthyroidism in childhood and adolescence is Graves’ disease. In this study, we aimed to evaluate the demographic characteristics, clinical and laboratory findings, treatment processes, and remission outcomes in patients followed up with the diagnosis of Graves’ disease. Methods: Medical records of 44 patients who were diagnosed with Graves’ disease in the period between 1999-2018 in our clinic, were retrospectively reviewed. Patients were included in the analysis according to risk groups (low, medium, and high) for relapses. Results: The median age of the patients was 13.2 years (9.2-15 years) and 35 (79.5%) of them were females. The most common complaints at the first admission were palpitations (52.3%) and sweating (52.3%), and the most common physical examination finding was tachycardia (43.1%) followed by goiter (40.9%). Propylthiouracil was started in 23 (52.3%) and methimazole in 21 (47.7%) patients. In the clinical follow-up, five patients (11.4%) achieved remission while relapses occurred in none of the patients. Among the patients who did not achieve remission, total thyroidectomy or radioactive iodine treatment were applied to 10 (25.6%) and four (10.2%) patients, respectively. As for the risk groups, 10 patients (35.7%) were in the low-risk, 17 (60.7%) in the moderate-risk, and one patient (3.6%) in the high-risk group. Remission occurred in two patients (20%) in the low-risk and in three patients (17.6%) in the moderate-risk group with a median time to remission being 25 and 18 months, respectively. Conclusion: In this study, remission rates were found to be low in pediatric Graves’ disease in accordance with the literature. We showed that long-term anti-thyroid therapy can be used to increase remission rates and alternative treatment options can be preferred in patients who are non-adherent to treatment and who do not achieve remission.
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spelling doaj-art-b65ff11a2e9846728bd482328f5e755a2025-08-20T02:45:14ZengAydın Pediatric SocietyTrends in Pediatrics2792-04292021-03-012110.59213/TP.2021.68077Evaluation of Clinical Characteristics and Treatment Outcomes of Graves Disease in Children and AdolescentsAlev Aldemir Sönmez0https://orcid.org/0000-0002-3023-1550Ibrahim Mert Erbas1https://orcid.org/0000-0001-9368-8868Sezer Acar2https://orcid.org/0000-0002-0768-835XKorcan Demir3https://orcid.org/0000-0002-8334-2422Ece Bober4https://orcid.org/0000-0001-8828-0892Ayhan Abaci5https://orcid.org/0000-0002-1812-0321Dokuz Eylul University Faculty of Medicine, Department of Pediatrics, Izmir, Turkey.Dokuz Eylul University Faculty of Medicine, Division of Pediatric Endocrinology, Izmir, TurkeyDokuz Eylul University Faculty of Medicine, Division of Pediatric Endocrinology, Izmir, TurkeyDokuz Eylul University Faculty of Medicine, Division of Pediatric Endocrinology, Izmir, TurkeyDokuz Eylul University Faculty of Medicine, Division of Pediatric Endocrinology, Izmir, TurkeyDokuz Eylul University Faculty of Medicine, Division of Pediatric Endocrinology, Izmir, Turkey Objective: The most common cause of hyperthyroidism in childhood and adolescence is Graves’ disease. In this study, we aimed to evaluate the demographic characteristics, clinical and laboratory findings, treatment processes, and remission outcomes in patients followed up with the diagnosis of Graves’ disease. Methods: Medical records of 44 patients who were diagnosed with Graves’ disease in the period between 1999-2018 in our clinic, were retrospectively reviewed. Patients were included in the analysis according to risk groups (low, medium, and high) for relapses. Results: The median age of the patients was 13.2 years (9.2-15 years) and 35 (79.5%) of them were females. The most common complaints at the first admission were palpitations (52.3%) and sweating (52.3%), and the most common physical examination finding was tachycardia (43.1%) followed by goiter (40.9%). Propylthiouracil was started in 23 (52.3%) and methimazole in 21 (47.7%) patients. In the clinical follow-up, five patients (11.4%) achieved remission while relapses occurred in none of the patients. Among the patients who did not achieve remission, total thyroidectomy or radioactive iodine treatment were applied to 10 (25.6%) and four (10.2%) patients, respectively. As for the risk groups, 10 patients (35.7%) were in the low-risk, 17 (60.7%) in the moderate-risk, and one patient (3.6%) in the high-risk group. Remission occurred in two patients (20%) in the low-risk and in three patients (17.6%) in the moderate-risk group with a median time to remission being 25 and 18 months, respectively. Conclusion: In this study, remission rates were found to be low in pediatric Graves’ disease in accordance with the literature. We showed that long-term anti-thyroid therapy can be used to increase remission rates and alternative treatment options can be preferred in patients who are non-adherent to treatment and who do not achieve remission. https://trendspediatrics.com/article/view/18Hyperthyroidismmethimazolepediatricsremissionrelapse.
spellingShingle Alev Aldemir Sönmez
Ibrahim Mert Erbas
Sezer Acar
Korcan Demir
Ece Bober
Ayhan Abaci
Evaluation of Clinical Characteristics and Treatment Outcomes of Graves Disease in Children and Adolescents
Trends in Pediatrics
Hyperthyroidism
methimazole
pediatrics
remission
relapse.
title Evaluation of Clinical Characteristics and Treatment Outcomes of Graves Disease in Children and Adolescents
title_full Evaluation of Clinical Characteristics and Treatment Outcomes of Graves Disease in Children and Adolescents
title_fullStr Evaluation of Clinical Characteristics and Treatment Outcomes of Graves Disease in Children and Adolescents
title_full_unstemmed Evaluation of Clinical Characteristics and Treatment Outcomes of Graves Disease in Children and Adolescents
title_short Evaluation of Clinical Characteristics and Treatment Outcomes of Graves Disease in Children and Adolescents
title_sort evaluation of clinical characteristics and treatment outcomes of graves disease in children and adolescents
topic Hyperthyroidism
methimazole
pediatrics
remission
relapse.
url https://trendspediatrics.com/article/view/18
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AT ibrahimmerterbas evaluationofclinicalcharacteristicsandtreatmentoutcomesofgravesdiseaseinchildrenandadolescents
AT sezeracar evaluationofclinicalcharacteristicsandtreatmentoutcomesofgravesdiseaseinchildrenandadolescents
AT korcandemir evaluationofclinicalcharacteristicsandtreatmentoutcomesofgravesdiseaseinchildrenandadolescents
AT ecebober evaluationofclinicalcharacteristicsandtreatmentoutcomesofgravesdiseaseinchildrenandadolescents
AT ayhanabaci evaluationofclinicalcharacteristicsandtreatmentoutcomesofgravesdiseaseinchildrenandadolescents