Mini Review

Graves’ Disease in Childhood: Advances in Management with Antithyroid Drug Therapy
Florentia Kaguelidou, Jean Claude Carel, Juliane Léger

Pediatric Endocrinology Department, Centre de Référence Maladies Endocriniennes de la Croissance, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Université Paris VII, Paris, France

Address of Corresponding Author

Horm Res 2009;71:310-317 (DOI: 10.1159/000223414)

  Key Words

• Graves’ disease
• Antithyroid drug therapy
• Recurrent hyperthyroidism

  Abstract

Graves’ disease is the most common cause of hyperthyroidism in children. Antithyroid drug (ATD) treatment is recommended as the initial treatment, leading to a marked improvement in most symptoms within 1 month of treatment initiation. Remission is achieved in 30% of children after a first course of ATD. Alternative treatments, such as radioactive iodine or thyroidectomy, are considered in cases of relapse, lack of compliance or ATD toxicity. The risk of relapse after a first course of ATD treatment for a median period of 2 years has been shown to be higher in patients with severe biochemical hyperthyroidism at diagnosis, young children and patients of non-Caucasian origin. Relapse risk decreases with the duration of the first course of ATD treatment, highlighting the positive impact of a long period of primary ATD treatment on outcome. The identification of predictive factors has made it possible to stratify patients according to the risk of relapse after ATD treatment, leading to improvements in patient management by facilitating the identification of patients requiring long-term ATD or early alternative therapy. Long-term careful follow-up is needed to determine the efficacy of disease management during childhood.

Copyright © 2009 S. Karger AG, Basel

  Author Contacts

Juliane Léger, MD
Pediatric Endocrinology Department, Hôpital Robert Debré
48 Bd Sérurier
FR–75019 Paris (France)
Tel. +33 1 40 03 23 54, Fax +33 1 40 03 24 29, E-Mail juliane.leger@rdb.aphp.fr

  Article Information

Jean Claude Carel and Juliane Léger are members of ESPE.

Received: February 4, 2009
Accepted: April 26, 2009
Published online: June 6, 2009
Number of Print Pages : 8
Number of Figures : 3, Number of Tables : 0, Number of References : 45