Efficacy and safety of radioiodine treatment of Graves’ disease in children and adolescents

Abstract

There are three methods in treatment of Graves disease in children and adolescents antithyroid drugs, surgery and radioiodine therapy (RIT). However, treatment protocol of children and adolescents doesnt exist. In the present case series study we have evaluated the effectiveness and safety of RIT in children and adolescents. We have observed totally 25 patients in age 1117 years old (mean 14.8 years) with Graves disease. Ten patients were treated with RIT in Endocrinology Research Centre (Moscow) in 2016 year with activities 550920 MBq. Follow-up period varied 611 months in this subgroup. The second subgroup (15 patients) was treated in radiology department in Nijniy Tagil rural hospital (Ural region) in the period 20052012 years. Follow-up period varied 3.511.5 years (mean 8.5 years). RIT was executed in all patients without any complications, direct or long-term. In two patients having endocrine ophtalmopathy in non-active phase it was no any signs of worsening in result of RIT. In 17 (68%) of 25 patients the hypothyroidism occurred through 6 months. In one case euthyroidism. In remain 7 observations the hyperthyroidism recurred. Patient subgroups didnt differ in mean age, gender ratio, thyroid size and autoantibodies to TSH receptor levels, but were differed in treatment 131I activities (subset from ERC 550920 MBq; subset from Nijniy Tagil 168400 MBq). However the treatment efficacy did not differ significantly (p = 0.99): 68% and 73%, accordingly. In conclusion, RIT of Graves disease in a safe and effective method of treatment for hyperthyroidism in children and adolescents. Its necessary to prolong study in numerous patients cohort, longer-lasting follow-up period as well as to improve RIT efficiency.

Keywords

• radioiodine treatment
• thyrotoxicosis
• children
• adolescents
• effectiveness
• safeness