Pediatric Graves' disease: therapeutic options and experience with radioiodine at the University of Mississippi Medical Center.
Pediatric Graves' disease can be life-threatening, and it adversely alters growth and development. Controversies concerning optimal therapy led us to review our 40 pediatric patients treated for Graves' disease from 1988 to 1996 to assess efficiency, efficacy, and safety of current therapy options. Diagnosis of Graves' disease required clinical hyperthyroidism with supportive laboratory studies. Patients were given informed choices of therapy, which divided them into three groups. In group 1, 17 patients received antithyroid medications for 0.3 years to 6.0 years. Three required surgical thyroidectomy. Remissions (with or without thyroxine therapy) were achieved after 2 years to 5 years in 11 (65%). In group 2, 15 patients received antithyroid medications for 0.3 years to 5.0 years before receiving radioactive iodine (131I). One also required surgical thyroidectomy. Remissions were achieved after 1 year to 5 years in 10 (67%). In group 3, eight patients received initial 131I therapy. Remissions were achieved within 1 year in 7 (88%). Our results agree with and expand upon published reports on Graves' disease. Our data support early use of 131I as efficient, effective, and safe therapy for pediatric Graves' disease.