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Radioiodine treatment for pediatric hyperthyroid Grave’s disease

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Grave’s disease (GD) is an autoimmune disease in which excessive amounts of thyroid hormones circulate in the blood. Treatment for pediatric GD includes (1) antithyroid drugs (ATD), (2) radioiodine, and (3) thyroidectomy. Yet, the optimal therapy remains controversial. We collected studies from all electronically available sources as well as from conferences held in China. All studies using radioiodine and/or ATD and/or thyroidectomy were included. Information was found on 1,874 pediatric GD patients treated with radioiodine, 1,279 patients treated with ATD and 1,362 patients treated surgically. The cure rate for radioiodine was 49.8%; the incidence of hypothyroidism, 37.8%; of relapse, 6.3%; of adverse effects, 1.55%; and of drop outs, 0.6%. These data show that radioiodine treatment is safe and effective in pediatric GD with significant lower incidence of relapse and adverse effects but significantly higher incidence of hypothyroidism as compared with both ATD and thyroidectomy. For the time being, radioiodine treatment for pediatric GD remains an excellent first-line therapy and a good second-line therapy for patients with ATD failure, severe complications, or poor compliance.

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We thank the Co-ordinator of the Metabolic and Endocrine Disorders Group and Dr. Bernd Richter, Gudrun Paletta, Susanne Ebrahim, contact editor, Dr. Wu Taixiang from Evidence based center West China Hospital are of invaluable help throughout the review and we are most grateful to them for their advice and support.

Conflicts of Interest

We stated that there are no financial or other relationships that might lead to a conflict of interest.

Author information

Correspondence to Ma Chao.

Additional information

The research project has been supported by national science fund (NO, 30700185).

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Chao, M., Jiawei, X., Guoming, W. et al. Radioiodine treatment for pediatric hyperthyroid Grave’s disease. Eur J Pediatr 168, 1165–1169 (2009). https://doi.org/10.1007/s00431-009-0992-2

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  • Radioiodine therapy
  • Thyrotoxicosis
  • Surgery
  • Graves’ disease
  • Adolescents
  • Antithyroid drug