ISSN: 2718-0085
Volume: 2 Issue: 01 Year: 2021
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Evaluation of Clinical Characteristics and Treatment Outcomes of Graves’’ Disease in Children and Adolescents [TIP]
TIP. 2021; 2(1): 18-27 | DOI: 10.5222/TP.2021.68077

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

Alev Aldemir Sönmez1, Ibrahim Mert Erbas2, Sezer Acar2, Korcan Demir2, Ece Bober2, Ayhan Abaci2
1Dokuz Eylul University Faculty of Medicine, Department of Pediatrics, Izmir, Turkey.
2Dokuz Eylul University Faculty of Medicine, Division of Pediatric Endocrinology, Izmir, Turkey

INTRODUCTION: 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.
DISCUSSION AND 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.

Keywords: Hyperthyroidism, methimazole, pediatrics, remission, relapse.

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. TIP. 2021; 2(1): 18-27

Corresponding Author: Alev Aldemir Sönmez, Türkiye
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