Graves' disease in children and adolescents. Late results of surgical treatment

1996 ◽  
Vol 134 (6) ◽  
pp. 710-715 ◽  
Author(s):  
Claes Rudberg ◽  
Henry Johansson ◽  
Göran Åkerström ◽  
Torsten Tuvemo ◽  
F Anders Karlsson
Keyword(s):  
Surgical Treatment ◽  
Medical Treatment ◽  
Children And Adolescents ◽  
Down's Syndrome ◽  
Antithyroid Drug ◽  
Down’S Syndrome ◽  
Late Results ◽  
Graves Disease

Rudberg C, Johansson H, ÅÅ G, Tuvemo T, Karlsson FA. Graves' disease in children and adolescents. Late results of surgical treatment. Eur J Endocrinol 1996;134:710–5. ISSN0804–4643 All children and adolescents with Graves' disease in the county of Uppsala (catchment area population 250000) treated between 1970 and 1994 were evaluated in a retrospective study. The material comprised 31 patients with a mean age of 11 years (range 4–16), 29 (94%) of whom were girls, and four (13%) of the patients had Down's syndrome. Treatment was primarily conservative and surgery was considered if prolonged medical treatment failed. Lasting remission after antithyroid drug therapy (median 6.5 years; range 4.5–8 years) was noted in 6/31 patients (19%), three (10%) of whom subsequently developed hypothyroidism. Twenty-four of the remaining patients (77%) ultimately underwent subtotal (N=20) or total thyroidectomy (N=4) after experiencing one or more episodes of recurrent hyperthyroidism during medical treatment (median 6 years; range 0.5–11 years). After surgery one patient developed permanent hypocalcemia requiring low-dose vitamin D supplementation. During a postoperative follow-up period of 12.2 years (median: range 1–17 years), there were two cases of recurrent thyrotoxicosis, 1 and 10 years after surgery. The results underline that gender and Down's syndrome are risk factors of juvenile Graves' disease and that the disorder often is difficult to control by long-term medical therapy. In such cases thyroid surgery offers a safe and prompt reversal of the thyrotoxicosis. A proportion of the patients may ultimately develop hypothyroidism, substantiating a need for long-term follow-up of persons afflicted with Graves' disease early in life. F Anders Karlsson, Department of Medicine, University Hospital, S-751 85 Uppsala. Sweden

scholarly journals Diet quality and well-being in children and adolescents: the UP&DOWN longitudinal study

2018 ◽  
Vol 121 (2) ◽  
pp. 221-231 ◽  
Author(s):  
Laura Esteban-Gonzalo ◽  
Anne I. Turner ◽  
Susan J. Torres ◽  
Irene Esteban-Cornejo ◽  
José Castro-Piñero ◽  
...  
Keyword(s):  
Secondary School ◽  
Negative Affect ◽  
Primary School ◽  
Positive Affect ◽  
Children And Adolescents ◽  
Down's Syndrome ◽  
Down’S Syndrome ◽  
Well Being ◽  
School Girls

AbstractThe present study examined the association between high-quality diet (using the Mediterranean diet (MD) as an example) and well-being cross-sectionally and prospectively in Spanish children and adolescents. Participants included 533 children and 987 adolescents at baseline and 527 children and 798 adolescents at 2-year follow-up, included in the UP&DOWN study (follow-up in schoolchildren and adolescents with and without Down’s syndrome). The present study excluded participants with Down’s syndrome. Adherence to an MD was assessed using the KIDMED index. Well-being was measured using the Positive and Negative Affect Schedule and the KIDSCREEN-10 questionnaire. Associations between MD adherence and well-being were assessed using multi-level, mixed-effects linear regression. At baseline, MD adherence was positively related to health-related quality of life in secondary school girls and boys (β=0·41,se0·10,P<0·001;β=0·46,se0·10,P<0·001, respectively) and to positive affect in secondary school girls and boys (β=0·16,se0·05,P=0·006;β=0·20,se0·05,P<0·001, respectively) and in primary school boys (β=0·20,se0·08,P=0·019). At 2-year follow-up, MD adherence was negatively related to negative affect in secondary school adolescent girls and boys (β=–0·15,se0·07,P=0·047;β=–0·16,se0·06,P=0·019, respectively), and MD adherence was associated with higher positive affect scores in secondary school girls (β=0·30,se0·06,P<0·001) and in primary school boys (β=0·20,se0·09,P=0·023). However, MD adherence at baseline did not predict well-being indicators at 2-year follow-up. In conclusion, higher MD adherence was found to behave as a protective factor for positive well-being in cross-sectional analysis.

LONG-TERM OUTCOMES OF RADIOIODINE THERAPY FOR JUVENILE GRAVES DISEASE WITH EMPHASIS ON SUBSEQUENTLY DETECTED THYROID NODULES: A SINGLE INSTITUTION EXPERIENCE FROM JAPAN

2020 ◽  
Vol 26 (7) ◽  
pp. 729-737 ◽  
Author(s):  
Tetsuya Mizokami ◽  
Katsuhiko Hamada ◽  
Tetsushi Maruta ◽  
Kiichiro Higashi ◽  
Junichi Tajiri
Keyword(s):  
Thyroid Gland ◽  
Thyroid Nodules ◽  
Radioiodine Therapy ◽  
Antithyroid Drug ◽  
Overt Hypothyroidism ◽  
Graves Disease ◽  
Outpatient Basis ◽  
Long Term Outcomes

Objective: To investigate the long-term outcomes of radioiodine therapy (RIT) for juvenile Graves disease (GD) and the ultrasonographic changes of the thyroid gland. Methods: All of 117 juvenile patients (25 males and 92 females, aged 10 to 18 [median 16] years) who had undergone RIT for GD at our clinic between 1999 and 2018 were retrospectively reviewed. Each RIT session was delivered on an outpatient basis. The maximum 131I dose per treatment was 13.0 mCi, and the total 131I dose per patient was 3.6 to 29.8 mCi (median, 13.0 mCi). 131I administration was performed once in 89 patients, twice in 26, and three times in 2 patients. Ultrasonography of the thyroid gland was regularly performed after RIT. The duration of follow-up after the initial RIT ranged from 4 to 226 (median 95) months. Results: At the latest follow-up more than 12 months after RIT (n = 111), the patients' thyroid functions were overt hypothyroidism (91%), subclinical hypothyroidism (2%), normal (5%), or subclinical hyperthyroidism (2%). New thyroid nodules were detected in 9 patients, 4 to 17 years after initial RIT. Patients with newly detected thyroid nodules underwent RIT with lower doses of 131I and had larger residual thyroid volumes than those without nodules. None of the patients were diagnosed with thyroid cancer or other malignancies during the follow-up period. Conclusion: Over a median follow-up period of 95 months (range, 4 to 226 months), RIT was found to be effective and safe in juvenile GD. However, cumulative evidence from further studies is required to confirm the long-term safety of RIT for juvenile GD. Abbreviations: ATD = antithyroid drug; GD = Graves disease; KI = potassium iodide; LT4 = levothyroxine; MMI = methimazole; PTU = propylthiouracil; RAIU = radio-active iodine uptake; RIT = radioiodine therapy; 99mTc = technetium-99m; TSH = thyrotropin

Immunodeficiency and plasma zinc levels in children with Down's syndrome: A long-term follow-up of oral zinc supplementation

1991 ◽  
Vol 58 (2) ◽  
pp. 207-216 ◽  
Author(s):  
A. Stabile ◽  
M.A. Pesaresi ◽  
A.M. Stabile ◽  
M. Pastore ◽  
S.Miceli Sopo ◽  
...  
Keyword(s):  
Zinc Supplementation ◽  
Down's Syndrome ◽  
Down’S Syndrome ◽  
Plasma Zinc ◽  
Long Term Follow Up ◽  
Zinc Levels

Long-term results of the surgical treatment of 129 intramedullary spinal gliomas

1981 ◽  
Vol 54 (3) ◽  
pp. 323-330 ◽  
Author(s):  
Beniamino Guidetti ◽  
Sandro Mercuri ◽  
Roberto Vagnozzi
Keyword(s):  
Surgical Treatment ◽  
Late Results ◽  
Long Term Results ◽  
Postoperative Results ◽  
Content Type ◽  
Fine Print ◽  
Spinal Gliomas

✓ The authors report the late results of surgical treatment of 129 intramedullary gliomas (48 ependymomas, 53 astrocytomas, 13 spongioblastomas, five glioblastomas, one oligodendroglioma, and nine others), with follow-up periods ranging from 1 to 27 years. The value of surgical treatment is considered in relation to the postoperative results.

HLA haplotype and serological markers for celiac disease in Down's syndrome patients: A long term follow-up

2008 ◽  
Vol 40 (10) ◽  
pp. A98
Author(s):  
L. Pensabene ◽  
D. Concolino ◽  
S. Sestito ◽  
G. Nigro ◽  
E. Focarelli ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Down's Syndrome ◽  
Down’S Syndrome ◽  
Serological Markers ◽  
Long Term Follow Up

Surgical treatment for Graves' disease: A long term follow-up of 325 patients

1981 ◽  
Vol 68 (2) ◽  
pp. 105-108 ◽  
Author(s):  
Shiro Noguchi ◽  
N. Murakami ◽  
A. Noguchi
Keyword(s):  
Surgical Treatment ◽  
Graves Disease ◽  
Long Term Follow Up

scholarly journals Long-Term Antithyroid Drug Treatment of Graves’ Disease in Children and Adolescents: A 20-Year Single-Center Experience

2021 ◽  
Vol 12 ◽  
Author(s):  
Ari Song ◽  
Su Jin Kim ◽  
Min-Sun Kim ◽  
Jiyeon Kim ◽  
Insung Kim ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Remission Rate ◽  
Antithyroid Drug ◽  
Thyroid Stimulating Hormone ◽  
Graves Disease ◽  
Tertiary Institution ◽  
Single Center Experience ◽  
Predicting Factors ◽  
The Mean

Background/purposeGraves’ 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.MethodsThis 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).ResultsA 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.ConclusionsIn 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.

scholarly journals Peculiarities of Graves' disease in children and adolescents with Down's syndrome

2010 ◽  
Vol 162 (3) ◽  
pp. 591-595 ◽  
Author(s):  
Filippo De Luca ◽  
Andrea Corrias ◽  
Mariacarolina Salerno ◽  
Malgorzata Wasniewska ◽  
Roberto Gastaldi ◽  
...  
Keyword(s):  
Autoimmune Diseases ◽  
Children And Adolescents ◽  
Clinical Course ◽  
Down's Syndrome ◽  
Down’S Syndrome ◽  
Serum Levels ◽  
Graves Disease ◽  
Radioiodine Ablation ◽  
Definitive Therapy ◽  
Clinical Changes

ObjectiveTo compare the presentation and clinical course of Graves' disease (GD) in two pediatric populations consisting of 28 patients with Down's syndrome (DS) and 109 controls without DS respectively.Design and methodsThe evolution over time of GD was determined in both groups according to the clinical changes and the variations in TSH, free thyroxine, and TSH receptor autoantibodies serum levels during the entire follow-up.ResultsFemale prevalence (50 vs 81.6%; χ2=12.0, P<0.0005) and average age at GD presentation (9.9±4.4 vs 11.5±3.5 years, P<0.05) were significantly lower in DS group than in controls. Clinical responsiveness to methimazole therapy was significantly better in DS patients, as demonstrated by both the lower relapse rates after the first cycle withdrawal (7.1 vs 31.2%; χ2=7.4, P<0.005) and the higher persistent remission rates after definitive therapy withdrawal (46.4 vs 26.7%; χ2=4.1, P<0.05). Moreover, in DS group, no patients needed surgery or radioiodine ablation, whereas non-pharmacological treatment was necessary in 11% of controls (χ2=3.8, P<0.05). Antecedents of Hashimoto's thyroiditis (HT) were documented in 21.4% of DS patients and in 3.7% of controls (χ2=10.4, P<0.005). Association with other autoimmune diseases was detected in 32.1% of DS cases and in 12.8% of controls (χ2=5.94, P<0.025).ConclusionsGD in DS children and adolescents is characterized by several peculiarities: i) earlier presentation; ii) no gender predominance; iii) less severe clinical course; iv) higher frequency of documented HT antecedents; v) more frequent association with other autoimmune diseases.

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

2013 ◽  
Vol 2 (1) ◽  
pp. 32-37 ◽  
Author(s):  
Adriano N Cury ◽  
Verônica T Meira ◽  
Osmar Monte ◽  
Marília Marone ◽  
Nilza M Scalissi ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Medical Records ◽  
Radioactive Iodine ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Age Group ◽  
Large Goiter ◽  
Definitive Therapy

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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