PMID- 34194397
OWN - NLM
STAT- MEDLINE
DCOM- 20211220
LR  - 20211220
IS  - 1664-2392 (Print)
IS  - 1664-2392 (Electronic)
IS  - 1664-2392 (Linking)
VI  - 12
DP  - 2021
TI  - Long-Term Antithyroid Drug Treatment of Graves' Disease in Children and 
      Adolescents: A 20-Year Single-Center Experience.
PG  - 687834
LID - 10.3389/fendo.2021.687834 [doi]
LID - 687834
AB  - BACKGROUND/PURPOSE: Graves' disease (GD) is the most common cause of 
      thyrotoxicosis in children and adolescents. There is some debate regarding the 
      optimal treatment and predicting factors of remission or relapse in children and 
      adolescents with GD. In this study, we report a retrospective study of 195 
      children and adolescents with GD treated at a single tertiary institution in 
      Korea. METHODS: This study included children and adolescents with GD diagnosed 
      before 19 years of age from January of 2000 to October of 2020. The diagnosis of 
      GD was based on clinical features, high thyroxine (FT4), suppressed 
      thyroid-stimulating hormone, and a positive titer of thyrotropin receptor 
      antibodies. Remission was defined as maintenance of euthyroid status for more 
      than six months after discontinuing antithyroid drug (ATD). RESULTS: A total of 
      195 patients with GD were included in this study. The mean age at diagnosis was 
      12.9 +/- 3.2 years, and 162 patients (83.1%) were female. Among all 195 patients, 
      five underwent thyroidectomy and three underwent radioactive iodine therapy. The 
      mean duration of follow-up and ATD treatment were 5.9 +/- 3.8 years and 4.7 +/- 3.4 
      years, respectively. The cumulative remission rates were 3.3%, 19.6%, 34.1%, 
      43.5%, and 50.6% within 1, 3, 5, 7, and 10 years of starting ATD, respectively. 
      FT4 level at diagnosis (P = 0.001) was predicting factors for remission [HR, 
      0.717 (95% CI, 0.591 - 0.870), P = 0.001]. Methimazole (MMI)-related adverse 
      events (AEs) occurred in 11.3% of patients, the most common of which were rash 
      and hematologic abnormalities. Of a total of 26 AEs, 19 (73.1%) occurred within 
      the first month of taking MMI. CONCLUSIONS: In this study, the cumulative 
      remission rate increased according to the ATD treatment duration. Long-term MMI 
      treatment is a useful treatment option before definite treatment in children and 
      adolescents with GD.
CI  - Copyright (c) 2021 Song, Kim, Kim, Kim, Kim, Bae, Seo, Cho, Choi, Cho and Jin.
FAU - Song, Ari
AU  - Song A
AD  - Department of Pediatrics, Incheon Sejong Hospital, Incheon, South Korea.
FAU - Kim, Su Jin
AU  - Kim SJ
AD  - Department of Pediatrics, Inha University Hospital, Inha University College of 
      Medicine, Incheon, South Korea.
FAU - Kim, Min-Sun
AU  - Kim MS
AD  - Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School 
      of Medicine, Seoul, South Korea.
FAU - Kim, Jiyeon
AU  - Kim J
AD  - Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School 
      of Medicine, Seoul, South Korea.
FAU - Kim, Insung
AU  - Kim I
AD  - Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School 
      of Medicine, Seoul, South Korea.
FAU - Bae, Ga Young
AU  - Bae GY
AD  - Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School 
      of Medicine, Seoul, South Korea.
FAU - Seo, Eunseop
AU  - Seo E
AD  - Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School 
      of Medicine, Seoul, South Korea.
FAU - Cho, Young Seok
AU  - Cho YS
AD  - Department of Nuclear Medicine and Molecular Imaging, Samsung Medical Center, 
      Sungkyunkwan University School of Medicine, Seoul, South Korea.
FAU - Choi, Joon Young
AU  - Choi JY
AD  - Department of Nuclear Medicine and Molecular Imaging, Samsung Medical Center, 
      Sungkyunkwan University School of Medicine, Seoul, South Korea.
FAU - Cho, Sung Yoon
AU  - Cho SY
AD  - Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School 
      of Medicine, Seoul, South Korea.
FAU - Jin, Dong-Kyu
AU  - Jin DK
AD  - Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School 
      of Medicine, Seoul, South Korea.
LA  - eng
PT  - Journal Article
DEP - 20210614
PL  - Switzerland
TA  - Front Endocrinol (Lausanne)
JT  - Frontiers in endocrinology
JID - 101555782
RN  - 0 (Antithyroid Agents)
RN  - 554Z48XN5E (Methimazole)
RN  - 721M9407IY (Propylthiouracil)
SB  - IM
MH  - Adolescent
MH  - Antithyroid Agents/*therapeutic use
MH  - Child
MH  - Female
MH  - Goiter/*drug therapy
MH  - Graves Disease/*drug therapy
MH  - Humans
MH  - Male
MH  - Methimazole/*therapeutic use
MH  - Propylthiouracil/*therapeutic use
MH  - Remission Induction
MH  - Retrospective Studies
MH  - Treatment Outcome
PMC - PMC8236938
OTO - NOTNLM
OT  - Graves' disease
OT  - antithyroid drugs
OT  - children
OT  - hyperthyroidism
OT  - remission
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2021/07/02 06:00
MHDA- 2021/12/21 06:00
PMCR- 2021/01/01
CRDT- 2021/07/01 06:56
PHST- 2021/03/30 00:00 [received]
PHST- 2021/05/31 00:00 [accepted]
PHST- 2021/07/01 06:56 [entrez]
PHST- 2021/07/02 06:00 [pubmed]
PHST- 2021/12/21 06:00 [medline]
PHST- 2021/01/01 00:00 [pmc-release]
AID - 10.3389/fendo.2021.687834 [doi]
PST - epublish
SO  - Front Endocrinol (Lausanne). 2021 Jun 14;12:687834. doi: 
      10.3389/fendo.2021.687834. eCollection 2021.