Abstract
In this study we have examined factors, present at diagnosis of juvenile thyrotoxicosis, for their possible prognostic significance with respect to outcome of antithyroid drug therapy. Thirty-six children (<17 years) were diagnosed and treated during 1972-1982. The material was characterized with respect to sex, age, tissue type (HLA-B8/DR3), thyroid hormone values, autoantibodies (TSH-receptor antibodies, TRAK; microsomal and thyroglobulin antibodies) and thyroid fine-needle biopsy at diagnosis. Mean period of anti-thyroid therapy 33 months, mean follow-up period 67 months. 22 pat. (61%) have either relapsed following withdrawal of antithyroid treatment (17/36) or have had to undergo surgery because of large goiter and/or poor response to medication (5/36). The remaining 14 pat. (39%) are still in remission. In the relapse vs remission group the presence of TRAK was 74% vs 18% and a lymphocytic thyroiditis at biopsy 33% vs 64%. None of the other factors examined at diagnosis differed. At follow-up the material was re-evaluated with biopsy and autoantibodies. Evidence of Hashimoto's thyroiditis (H) was found in six patients all in remission. The other pat. were classified as Grave's disease (G) and only 8 (27%) were in remission. It is obvious that there is a need for better diagnostic and prognostic tools to avoid long term treatment in H. and consider alternative therapy in G.
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Wilton, P., Dahlberg, P. & Karisson, F. HETEROGENEITY IN JUVENILE THYROTOXICOSIS. Pediatr Res 20, 1195 (1986). https://doi.org/10.1203/00006450-198611000-00130
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DOI: https://doi.org/10.1203/00006450-198611000-00130