Graves' disease in children and adolescents: Response to long‐term treatment

Barrio, Raquel; López-Capapé, M.; Martinez‐Badás, Itziar; Carrillo, Ángel; Moreno, José; Alonso, Milagros

doi:10.1080/08035250500252872

Cited by 35 publications

(24 citation statements)

References 32 publications

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“…Twenty-one trials (1,239 patients) used ATD as intervention [1, 5, 7-9, 12, 17, 18, 22, 23, 27, 28, 31-34, 36, 39, 40, 49, 51], of which five (207 patients) were published in Chinese. Twenty-five trials (1,362 patients) used thyroidectomy as intervention [2,4,5,7,11,18,23,28,30,33,37,38,49,53,56,57,[61][62][63][64][65][66][67][68]70], of which 13 (681patients) were published in Chinese. The follow-up periods were from 1 to 36 years.…”

Section: Results Of Searchmentioning

confidence: 99%

Radioiodine treatment for pediatric hyperthyroid Grave’s disease

et al. 2009

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Grave's disease (GD) is an autoimmune disease in which excessive amounts of thyroid hormones circulate in the blood. Treatment for pediatric GD includes (1) antithyroid drugs (ATD), (2) radioiodine, and (3) thyroidectomy. Yet, the optimal therapy remains controversial. We collected studies from all electronically available sources as well as from conferences held in China. All studies using radioiodine and/or ATD and/or thyroidectomy were included. Information was found on 1,874 pediatric GD patients treated with radioiodine, 1,279 patients treated with ATD and 1,362 patients treated surgically. The cure rate for radioiodine was 49.8%; the incidence of hypothyroidism, 37.8%; of relapse, 6.3%; of adverse effects, 1.55%; and of drop outs, 0.6%. These data show that radioiodine treatment is safe and effective in pediatric GD with significant lower incidence of relapse and adverse effects but significantly higher incidence of hypothyroidism as compared with both ATD and thyroidectomy. For the time being, radioiodine treatment for pediatric GD remains an excellent first-line therapy and a good second-line therapy for patients with ATD failure, severe complications, or poor compliance.

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Section: Results Of Searchmentioning

confidence: 99%

Radioiodine treatment for pediatric hyperthyroid Grave’s disease

et al. 2009

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“…Estos últimos suelen asociar menores efectos adversos, sin embargo, a excepción de la Clozapina, también se asocian a disquinesia tardía. (12,13) En niños se han utilizado risperidona y olanzapina a partir de los 12 años de edad. Estos tienen menor efecto sedante que los neurolépticos tradicionales como el Haloperidol, Flufenazina, Tioridazina y Clorpromazina.…”

Section: Discussionunclassified

Hipertiroidismo y Psicosis en Pediatría: Reporte de Caso

2015

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RESUMENLa enfermedad de Graves es un desorden autoinmune que constituye la principal causa de hipertiroidismo en niños; usualmente se manifiesta con bocio difuso, signos de oftalmopatía bilateral y la alteración bioquímica en las pruebas de función tiroidea. En ocasiones, los síntomas iniciales se presentan con manifestaciones psiquiátricas, lo que llega a ser un reto en el diagnóstico diferencial, ya sea del trastorno tiroideo primario o un trastorno psiquiátrico. Debido a la poca frecuencia con que esta manifestación de la enfermedad de graves se presenta en pediatría se expone aquí el caso de hipertiroidismo y psicosis aguda en un paciente pediátrico. PALABRAS CLAVEHipertiroidismo, Niños, Enfermedad de Graves, Psicosis aguda ABSTRACT Graves's disease is the most common cause of hyperthyroidism in children and adolescents. Generally presents itself as a diffuse goiter, clinical findings of bilateral ophthalmopathy and abnormal laboratory results in the thyroid function test. Sometimes, the psychiatric manifestations become the initial symptoms, what turns the differential diagnoses, from either the primary thyroid disorder or the psychiatric disease, in quite a challenge. Because of the low incidence of psychosis as manifestation of Graves' disease in children, we present a case of hyperthyroidism and acute psychosis in a child. KEYWORDSHyperthyroidism, children, Graves' disease, Psychosis. CASO CLINICOUn paciente masculino, costarricense, de 12 años de edad, fue admitido en el Hospital nacional de niños "Dr. Carlos Sáenz Herrera" por historia de alteración del comportamiento, bocio, proptosis, y alucinaciones visuales.El paciente es conocido sano, viviendo en albergue del PANI (Patronato Nacional de la Infancia, Costa Rica), con historia de alucinaciones que consistía en ver un "niño de 5 años de edad, pequeño, vestido de blanco, con espirales rojas en el pecho, el cual le decía que quemara el albergue donde se encontraba en ese momento, ya que no era un buen lugar". Las alucinaciones visuales del paciente durante esa semana se hicieron más frecuentes y además, comenzó a presentar un comportamiento agresivo, apático, ansioso, asociando irritación ocular, diaforesis, insomnio e inquietud por lo que los encargados del menor deciden consultar al hospital nacional psiquiátrico. Fue valorado

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“…Remission is achieved in less than 30% of children after a first course of ATD for about 2 years (18). In children, studies have shown that a longer initial duration of euthyroid state with ATD is associated with a lower risk of relapse after a first course of ATD therapy (18,19).…”

Section: No1 February 2013mentioning

confidence: 99%

“…It suggested that children with Graves' disease who display good compliance with treatment and with no major adverse effects of ATD may be offered up to 8-10 years of medical treatment before definitive treatment is considered (20). As with studies done in adults, long term therapy with carbimazole/ methimazole has been shown to be safe without any major adverse effects (19,20).…”

Section: No1 February 2013mentioning

confidence: 99%

The role of long term use of antithyroid drugs in Graves’ disease

Abhayaratna¹,

Somasundaram

2013

Sri Lanka J. Diabetes Endocrinol. Metab.

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Graves' disease is an autoimmune disease characterized by hyperthyroidism due to circulating autoantibodies. Radioactive iodine (RAI) and antithyroid drugs (ATD) are the preferred initial treatment options in Graves' disease in many parts of the world. Long term treatment with methimazole in Grave's disease patients beyond the recommended period is shown to be safe and effective and emerging evidence suggests that continuous methimazole therapy may even be superior to RAI therapy in some aspects. Recent randomized trials comparing long-term methimazole to RAI in patients who relapse, have confirmed these findings.

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Graves' disease in children and adolescents: Response to long‐term treatment

Cited by 35 publications

References 32 publications

Radioiodine treatment for pediatric hyperthyroid Grave’s disease

Radioiodine treatment for pediatric hyperthyroid Grave’s disease

Hipertiroidismo y Psicosis en Pediatría: Reporte de Caso

The role of long term use of antithyroid drugs in Graves’ disease

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