Long-term outcomes of graves disease in children treated with anti-thyroid drugs
Background: Graves disease (GD) is the most common cause of thyrotoxicosis in children and adolescents, accounting for 15% of all thyroid diseases during childhood. Anti-thyroid drugs (ATD) are recommended as the first-line treatment in children and adolescents. However, the remission rate is lower...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-06-01
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| Series: | Pediatrics and Neonatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957219305595 |
| _version_ | 1819064682353262592 |
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| author | Ya-Ting Chiang Wei-Hsin Ting Chi-Yu Huang Shih-Kang Huang Chon-In Chan Bi-Wen Cheng Chao-Hsu Lin Yi-Lei Wu Chen-Mei Hung Hsin-Jung Li Chia-Jung Chan Yann-Jinn Lee |
| author_facet | Ya-Ting Chiang Wei-Hsin Ting Chi-Yu Huang Shih-Kang Huang Chon-In Chan Bi-Wen Cheng Chao-Hsu Lin Yi-Lei Wu Chen-Mei Hung Hsin-Jung Li Chia-Jung Chan Yann-Jinn Lee |
| author_sort | Ya-Ting Chiang |
| collection | DOAJ |
| description | Background: Graves disease (GD) is the most common cause of thyrotoxicosis in children and adolescents, accounting for 15% of all thyroid diseases during childhood. Anti-thyroid drugs (ATD) are recommended as the first-line treatment in children and adolescents. However, the remission rate is lower in children than in adults, and the optimal treatment duration and favorable factors associated with remission remain unknown. We aimed to investigate long-term outcomes of pediatric GD patients receiving ATD. Methods: We retrospectively reviewed medical charts of 396 GD subjects from 1985 to 2017 at MacKay Children's Hospital. Ninety–six patients were excluded from the analyses, including 71 patients followed for less than one year, 6 patients who received radioactive therapy and 19 patients who received surgery. The remaining 300 patients initially treated with ATD and followed up for more than 1 year constituted our study population. Results: The 300 patients comprised 257 (85.7%) females and 43 (14.3%) males. Their median age at diagnosis was 11.6 (range 2.7–17.8) years with 11 patients (3.7%) younger than 5 years. Their median follow-up period was 4.7 (range 1.1–23.9) years. Overall, 122 patients achieved the criteria for discontinuing ATD treatment, and seventy-nine (39.9%) patients achieved remission, with a median follow-up period of 5.3 (range 1.5–20.1) years. Patients in the remission group were more likely to be aged <5 years (remission vs. relapse vs. ongoing ATD; 11.4 vs. 0 vs. 2.6%, P = 0.02), less likely to have a family history of thyroid disease (24.1 vs. 42.1 vs. 52.6%, P = 0.001), and had lower TSH receptor antibody (TRAb) levels (42.8 vs. 53.6 vs. 65.1%, P = 0.02) at the time of diagnosis. Conclusion: Long-term ATD remains an effective treatment option for GD in children. Pediatric GD patients aged <5 years, having no family history of thyroid disease and having initial lower TRAb levels were more likely to achieve remission. |
| first_indexed | 2024-12-21T15:34:27Z |
| format | Article |
| id | doaj.art-7767441a44534641a6de99d108341dbe |
| institution | Directory Open Access Journal |
| issn | 1875-9572 |
| language | English |
| last_indexed | 2024-12-21T15:34:27Z |
| publishDate | 2020-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj.art-7767441a44534641a6de99d108341dbe2022-12-21T18:58:41ZengElsevierPediatrics and Neonatology1875-95722020-06-01613311317Long-term outcomes of graves disease in children treated with anti-thyroid drugsYa-Ting Chiang0Wei-Hsin Ting1Chi-Yu Huang2Shih-Kang Huang3Chon-In Chan4Bi-Wen Cheng5Chao-Hsu Lin6Yi-Lei Wu7Chen-Mei Hung8Hsin-Jung Li9Chia-Jung Chan10Yann-Jinn Lee11Department of Pediatric Endocrinology, MacKay Children's Hospital, Taipei, Taiwan; Department of Pediatric Endocrinology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, TaiwanDepartment of Pediatric Endocrinology, MacKay Children's Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; MacKay Junior College of Medicine, Nursing and Management, New Taipei City, Taiwan; Corresponding author. Department of Pediatric Endocrinology, MacKay Children's Hospital, Taipei, TaiwanDepartment of Pediatric Endocrinology, MacKay Children's Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, TaiwanDepartment of Pediatric Endocrinology, MacKay Children's Hospital, Taipei, TaiwanDepartment of Pediatric Endocrinology, MacKay Children's Hospital, Taipei, TaiwanDepartment of Pediatrics, MacKay Memorial Hospital HsinChu, Hsin-Chu, TaiwanDepartment of Pediatrics, MacKay Memorial Hospital HsinChu, Hsin-Chu, TaiwanDepartment of Pediatrics, Changhua Christian Hospital, Chang-Hua, TaiwanDepartment of Pediatrics, Hsinchu Cathay General Hospital, Hsin-Chu, TaiwanDepartment of Pediatrics, St. Martin De Porres Hospital, Chia-Yi, TaiwanChiahung Clinic, Taichung, TaiwanDepartment of Pediatric Endocrinology, MacKay Children's Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; Department of Medical Research, MacKay Memorial Hospital Tamsui, New Taipei City, Taiwan; Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Institute of Biomedical Sciences, MacKay Medical College, New Taipei City, Taiwan; Corresponding author. Department of Pediatric Endocrinology, MacKay Children's Hospital, Taipei, Taiwan.Background: Graves disease (GD) is the most common cause of thyrotoxicosis in children and adolescents, accounting for 15% of all thyroid diseases during childhood. Anti-thyroid drugs (ATD) are recommended as the first-line treatment in children and adolescents. However, the remission rate is lower in children than in adults, and the optimal treatment duration and favorable factors associated with remission remain unknown. We aimed to investigate long-term outcomes of pediatric GD patients receiving ATD. Methods: We retrospectively reviewed medical charts of 396 GD subjects from 1985 to 2017 at MacKay Children's Hospital. Ninety–six patients were excluded from the analyses, including 71 patients followed for less than one year, 6 patients who received radioactive therapy and 19 patients who received surgery. The remaining 300 patients initially treated with ATD and followed up for more than 1 year constituted our study population. Results: The 300 patients comprised 257 (85.7%) females and 43 (14.3%) males. Their median age at diagnosis was 11.6 (range 2.7–17.8) years with 11 patients (3.7%) younger than 5 years. Their median follow-up period was 4.7 (range 1.1–23.9) years. Overall, 122 patients achieved the criteria for discontinuing ATD treatment, and seventy-nine (39.9%) patients achieved remission, with a median follow-up period of 5.3 (range 1.5–20.1) years. Patients in the remission group were more likely to be aged <5 years (remission vs. relapse vs. ongoing ATD; 11.4 vs. 0 vs. 2.6%, P = 0.02), less likely to have a family history of thyroid disease (24.1 vs. 42.1 vs. 52.6%, P = 0.001), and had lower TSH receptor antibody (TRAb) levels (42.8 vs. 53.6 vs. 65.1%, P = 0.02) at the time of diagnosis. Conclusion: Long-term ATD remains an effective treatment option for GD in children. Pediatric GD patients aged <5 years, having no family history of thyroid disease and having initial lower TRAb levels were more likely to achieve remission.http://www.sciencedirect.com/science/article/pii/S1875957219305595adolescentsantithyroid drugschildrengraves disease |
| spellingShingle | Ya-Ting Chiang Wei-Hsin Ting Chi-Yu Huang Shih-Kang Huang Chon-In Chan Bi-Wen Cheng Chao-Hsu Lin Yi-Lei Wu Chen-Mei Hung Hsin-Jung Li Chia-Jung Chan Yann-Jinn Lee Long-term outcomes of graves disease in children treated with anti-thyroid drugs Pediatrics and Neonatology adolescents antithyroid drugs children graves disease |
| title | Long-term outcomes of graves disease in children treated with anti-thyroid drugs |
| title_full | Long-term outcomes of graves disease in children treated with anti-thyroid drugs |
| title_fullStr | Long-term outcomes of graves disease in children treated with anti-thyroid drugs |
| title_full_unstemmed | Long-term outcomes of graves disease in children treated with anti-thyroid drugs |
| title_short | Long-term outcomes of graves disease in children treated with anti-thyroid drugs |
| title_sort | long term outcomes of graves disease in children treated with anti thyroid drugs |
| topic | adolescents antithyroid drugs children graves disease |
| url | http://www.sciencedirect.com/science/article/pii/S1875957219305595 |
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