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. 2012 Dec 5;2(1):32-7.
doi: 10.1530/EC-12-0049. Print 2013 Mar 1.

Clinical experience with radioactive iodine in the treatment of childhood and adolescent Graves' disease

Adriano N Cury  1 , Verônica T Meira, Osmar Monte, Marília Marone, Nilza M Scalissi, Cristiane Kochi, Luís E P Calliari, Carlos A Longui
Affiliations

Clinical experience with radioactive iodine in the treatment of childhood and adolescent Graves' disease

Adriano N Cury et al. Endocr Connect. .

Abstract

Background/aims: Treatments for Graves' disease (GD) in children and adolescents include oral antithyroid drugs (ATDs), near total thyroidectomy, and radioactive iodine (RAI). ATDs remain the preferred choice in this age group, but because persistent remission occurs in 30% of cases, RAI is becoming a common option for definitive therapy.

Methods: We performed a review of 65 medical records of GD patients under age 19 years who were followed between 1985 and 2005.

Results: The prevalence of GD was higher in females (3:1) and during puberty (for both genders). If no remission was detected during ATD treatment, RAI was indicated when the following criteria were present: non-compliance, relapse, or side effects that were related to ATDs, large goiter, and long-term use of ATDs. The majority of patients developed hypothyroidism within 6 months after RAI. A progressive higher dose regimen was implemented in the last 10 years of the study period. A second RAI dose was necessary in eight cases. During the follow-up period, three pregnancies occurred. One patient with a thyroid nodule and benign cytology was detected.

Conclusions: RAI therapy is effective and safe in the treatment of GD in children and adolescents.

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Figures

Figure 1
Figure 1
Age distribution of children at diagnosis of GD.
Figure 2
Figure 2
Distribution of RAI doses in 65 patients with GD.
Figure 3
Figure 3
Average RAI dose during the study period.
Figure 4
Figure 4
Treatment and outcomes in pediatric population with Graves' disease. ATDs, antithyroid drugs; l-T4, levothyroxine.
See this image and copyright information in PMC

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