Abstract
At present, no laboratory test is available to predict the evolution of Graves' disease. A follow up of 1 to 14 y. in 59 patients aged 2 4/12 to 17 y. old (X̄±SD: 9.4±3.9) is presented. They all received antithyroid drugs as initial treatment, 7 were treated with 131I for intolerance or social problems. Thirty six patients followed for 3 to 14 y., could be reevaluated with T4, T3 and TSH and/or TRH after treatment in at least 2 occasions, at short term (ST: 1-2 y. post onset of treatment) and at long term (LT: more than 3 y.; X̄: 6.2±3.3). According to thyroid status at ST and LT respectively 3 groups were found: I) hyperthyroidism (Hper) and Hper n=23, 64%; II) Hper and hypo or euthyroidism (Hpo/Eu) n=4, 11%; III)Hpo/Eu and Hpo/Eu n=9, 25%. No patient changed from Hpo to Hper. Eighty nine percent of patients did not modify their thyroid function between ST and LT. The influence of age at admission on persistence of Hper 3 y. later was also studied. Fourteen out of 16 patients (87.5%) less than 8 y. were still Hper while only 14 out of 24 (58.3%) were Hper after 8 y. old. It is concluded that evaluation of thyroid function at ST is useful to predict thyroid status at LT since 90% of patients showed no variations. Patients developing Graves' disease before the age of 8 y. have a high chance of remaining Hper 3 y. later. If Hper persits at ST evaluation, the possibility of 131I adminstration should be considered to avoid the excessively long treatment required by the unrelenting course of this disease.
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Iorcansky, S., de Papendieck, L., Belgorosky, A. et al. FOLLOW UP OF JUVENILE HYPERTHYROIDISM: THYROID FUNCTION AT SHORT-TERM AS PREDICTOR OF THE EVOLUTION. Pediatr Res 20, 1195 (1986). https://doi.org/10.1203/00006450-198611000-00131
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DOI: https://doi.org/10.1203/00006450-198611000-00131