Management of Thyrotoxicosis in Children and Adolescents: A Turkish Multi-center Experience
Journal Title: Journal of Clinical Research in Pediatric Endocrinology - Year 2019, Vol 11, Issue 2
Abstract
Objective: To determine the demographic and biochemical features of childhood and juvenile thyrotoxicosis and treatment outcome. Methods: We reviewed the records of children from 22 centers in Turkey who were diagnosed with thyrotoxicosis between 2007 to 2017. Results: A total of 503 children had been diagnosed with thyrotoxicosis at the centers during the study period. Of these, 375 (74.6%) had been diagnosed with Graves’ disease (GD), 75 (14.9%) with hashitoxicosis and 53 (10.5%) with other less common causes of thyrotoxicosis. The most common presenting features in children with GD or hashitoxicosis were tachycardia and/or palpitations, weight loss and excessive sweating. The cumulative remission rate was 17.6% in 370 patients with GD who had received anti-thyroid drugs (ATDs) for initial treatment. The median (range) treatment period was 22.8 (0.3-127) months. No variables predictive of achieving remission were identified. Twenty-seven received second-line treatment because of poor disease control and/or adverse events associated with ATDs. Total thyroidectomy was performed in 17 patients with no recurrence of thyrotoxicosis and all became hypothyroid. Ten patients received radioiodine and six became hypothyroid, one remained hyperthyroid and restarted ATDs and one patient achieved remission. Two patients were lost to follow up. Conclusion: This study has demonstrated that using ATDs is the generally accepted first-line approach and there seems to be low remission rate with ATDs in pediatric GD patients in Turkey.
Authors and Affiliations
İhsan Esen, Elvan Bayramoğlu, Melek Yıldız, Murat Aydın, Esin Karakılıç Özturhan, Zehra Aycan, Semih Bolu, Hasan Önal, Yılmaz Kör, Deniz Ökdemir, Edip Ünal, Aşan Önder, Olcay Evliyaoğlu, Atilla Çayır, Mehmet Taştan, Ayşegül Yüksel, Aylin Kılınç, Muammer Büyükinan, Bahar Özcabı, Onur Akın, Çiğdem Binay, Suna Kılınç, Ruken Yıldırım, Emel Hatun Aytaç, Elif Sağsak
Keywords
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- EP ID EP581917
- DOI 10.4274/jcrpe.galenos.2018.2018.0210
- Views 193
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