A survey of the young person’s experience of Graves’ disease and its management

Lane, Laura C; Rankin, Judith; Cheetham, Tim

doi:10.1111/cen.14359

Cited by 9 publications

(10 citation statements)

References 29 publications

(68 reference statements)

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“…In a recent study in young people who were diagnosed with and treated for GD in childhood, QoL was found to be lower than in healthy controls, especially in the psychosocial domain. Although more research on this topic is needed, it emphasizes the need for additional support for young people with GD, both at school and from a psychological perspective ( 98 ).…”

Section: Prognosismentioning

confidence: 99%

2022 European Thyroid Association Guideline for the management of pediatric Graves’ disease

Mooij

Cheetham

Verburg

et al. 2022

European Thyroid Journal

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Hyperthyroidism caused by Graves’ disease (GD) is a relatively rare disease in children. Treatment options are the same as in adults – antithyroid drugs (ATD), radioactive iodine (RAI) or thyroid surgery, but the risks and benefits of each modality are different. The European Thyroid Association guideline provides new recommendations for the management of pediatric GD with and without orbitopathy. Clinicians should be alert that GD may present with behavioral changes or declining academic performance in children. Measurement of serum TSH receptor antibodies is recommended for all pediatric patients with hyperthyroidism. Management recommendations include the first-line use of a prolonged course of methimazole/carbimazole ATD treatment (3 years or more), a preference for dose titration instead of block and replace ATD, and to avoid propylthiouracil use. Where definitive treatment is required either total thyroidectomy or RAI is recommended, aiming for complete thyroid ablation with a personalized RAI activity. We recommend avoiding RAI in children under 10 years of age but favor surgery in patients with large goiter. Pediatric endocrinologists should be involved in all cases.

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Section: Prognosismentioning

confidence: 99%

2022 European Thyroid Association Guideline for the management of pediatric Graves’ disease

Mooij

Cheetham

Verburg

et al. 2022

European Thyroid Journal

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“…The patient who is TPO antibody positive 1–2 years post antithyroid drug still needs monitoring to make sure that they remain euthyroid. There is relatively little data on quality of life in people with GD although a recent study has shown that young Graves’ patients have a lower total QoL score compared with a healthy cohort [ 45 ]. Individuals who chose definitive treatment with RAI or surgery did not regret this decision.…”

Section: Introductionmentioning

confidence: 99%

How to use thionamide anti-thyroid drug in the young– what’s new?

Cheetham

2021

Thyroid Res

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The excess thyroid hormone secretion that characterises Graves’ disease (GD) is generated when stimulatory antibodies bind to the thyroid stimulating hormone receptor on the follicular cell of the thyroid gland.This underlying mechanism cannot easily be abolished and the mainstay of Graves’ disease (GD) management in the young remains thionamide anti-thyroid drug (ATD). Unfortunately, GD will usually recur after a 2 or 3 year course of ATD, even when the stimulatory antibody titres have fallen. The diagnosis of GD therefore usually signals the start of a lengthy period of out-patient assessments and associated venepuncture. Careful, more protracted administration of ATD may increase the likelihood of longer-term remission and reduce the likelihood of the patient developing ATD side-effects. An understanding of how best to use ATD and an awareness of the less well-known consequences of GD and its’ treatment - such as excessive weight-gain and long-term hypothyroidism – are also of fundamental importance.Recent clinical studies have shed light on how best to manage the young patient with GD and the associated new information will help to answer some of the questions posed by the young person and their family at diagnosis. This new knowledge is the focus of this article about ATD therapy in the young.

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“…The short-term and long-term impact of GD on the young person from a physical, psychological and social perspective should not be underestimated. Indeed, patients with GD who were treated in childhood or adolescence report a lower quality of life than their healthy peers, particularly in the psychosocial domain 37. In addition, adult studies have reported that thyroid hormone replacement is associated with a reduced quality of life compared with controls 38.…”

Section: Quality Of Lifementioning

confidence: 99%

Graves’ disease: moving forwards

2022

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Graves’ disease is a rare disorder that continues to present clinicians and families with a series of challenges. There are no new established treatments for children or adolescents, but the outcomes of recent clinical trials and meta-analyses have helped clinicians to prepare families for the road ahead. We have a more refined understanding of how to administer antithyroid drugs, which one to use and how long to treat the young person. We also have a greater insight into how best to reduce any risks associated with surgery and radioiodine. We understand more about long-term outcomes and their determinants and have greater awareness about the impact of the disease and its treatment on quality of life. A holistic approach to management is key to supporting and counselling young people and their families about the diagnosis and management options. In this review, we will discuss the recent literature and reflect on how this should be translated into clinical practice.

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A survey of the young person’s experience of Graves’ disease and its management

Cited by 9 publications

References 29 publications

2022 European Thyroid Association Guideline for the management of pediatric Graves’ disease

2022 European Thyroid Association Guideline for the management of pediatric Graves’ disease

How to use thionamide anti-thyroid drug in the young– what’s new?

Graves’ disease: moving forwards

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