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KMID : 0648420100150020100
Journal of Korean Society of Pediatric Endocrinology
2010 Volume.15 No. 2 p.100 ~ p.105
Remission Predictors of Graves` Disease in Children
Kim Shin-Mi

Hwang Jin-Soon
Abstract
Purpose : Antithyroid drug treatment is usually recommended as the initial treatment for children with Graves¡¯ disease. However, achieving remission with medical therapy usually requires many years of treatment, the risk for adverse reactions is relatively high and relapse is common after discontinuation of medication. There is therefore a debate about how Graves¡¯ disease should be treated in children. The aim of this study was to identify predictors of remission during 2 years from quitting of antithyroid drug.

Methods : We retrospectively studied children who had been treated for Graves¡¯ disease with antithyroid medication. We compared the children who achieved remission after two years with those who had persistent disease, to determine the variables associated with remission.

Results : 41 patients were enrolled, of whom five (12.2%) achieved remission and the rest (87.8%) could not achieve remission until the last visit. There were no significant differences in T3, free T4, antimicrosomal antibody (AMA), or thyroid stimulating hormone (TSH)-binding inhibitory immunoglobulin (TBII) between the two groups at presentation. However, the remission group had a significantly higher titer of TSH (P =0.04) and a significantly lower titer of antithyroglobulin antibody (ATA) (P=0.01) than the non-remission group at presentation. The non-remission group had higher ATA concentrations 3 months after treatment with antithyroid medication than the remission group did (P=0.02).

Conclusion : TSH and ATA concentrations at presentation can be used to stratify patients according to the likelihood of remission during 2 years from quitting of antithyroid drug.
KEYWORD
Graves` disease, Antithyroid agents, Remission induction
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