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2022 European Thyroid Association Guideline for the management of pediatric Graves’ disease
Hyperthyroidism caused by Graves’ disease (GD) is a relatively rare disease in children. Treatment options are the same as in adults – antithyroid drugs (ATD), radioactive iodine (RAI) or thyroid surgery, but the risks and benefits of each modality are different. The European Thyroid Association gui...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Bioscientifica Ltd
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9142815/ https://www.ncbi.nlm.nih.gov/pubmed/34981748 http://dx.doi.org/10.1530/ETJ-21-0073 |
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author | Mooij, Christiaan F Cheetham, Timothy D Verburg, Frederik A Eckstein, Anja Pearce, Simon H Léger, Juliane van Trotsenburg, A S Paul |
author_facet | Mooij, Christiaan F Cheetham, Timothy D Verburg, Frederik A Eckstein, Anja Pearce, Simon H Léger, Juliane van Trotsenburg, A S Paul |
author_sort | Mooij, Christiaan F |
collection | PubMed |
description | Hyperthyroidism caused by Graves’ disease (GD) is a relatively rare disease in children. Treatment options are the same as in adults – antithyroid drugs (ATD), radioactive iodine (RAI) or thyroid surgery, but the risks and benefits of each modality are different. The European Thyroid Association guideline provides new recommendations for the management of pediatric GD with and without orbitopathy. Clinicians should be alert that GD may present with behavioral changes or declining academic performance in children. Measurement of serum TSH receptor antibodies is recommended for all pediatric patients with hyperthyroidism. Management recommendations include the first-line use of a prolonged course of methimazole/carbimazole ATD treatment (3 years or more), a preference for dose titration instead of block and replace ATD, and to avoid propylthiouracil use. Where definitive treatment is required either total thyroidectomy or RAI is recommended, aiming for complete thyroid ablation with a personalized RAI activity. We recommend avoiding RAI in children under 10 years of age but favor surgery in patients with large goiter. Pediatric endocrinologists should be involved in all cases. |
format | Online Article Text |
id | pubmed-9142815 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Bioscientifica Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-91428152022-05-31 2022 European Thyroid Association Guideline for the management of pediatric Graves’ disease Mooij, Christiaan F Cheetham, Timothy D Verburg, Frederik A Eckstein, Anja Pearce, Simon H Léger, Juliane van Trotsenburg, A S Paul Eur Thyroid J Guidelines Hyperthyroidism caused by Graves’ disease (GD) is a relatively rare disease in children. Treatment options are the same as in adults – antithyroid drugs (ATD), radioactive iodine (RAI) or thyroid surgery, but the risks and benefits of each modality are different. The European Thyroid Association guideline provides new recommendations for the management of pediatric GD with and without orbitopathy. Clinicians should be alert that GD may present with behavioral changes or declining academic performance in children. Measurement of serum TSH receptor antibodies is recommended for all pediatric patients with hyperthyroidism. Management recommendations include the first-line use of a prolonged course of methimazole/carbimazole ATD treatment (3 years or more), a preference for dose titration instead of block and replace ATD, and to avoid propylthiouracil use. Where definitive treatment is required either total thyroidectomy or RAI is recommended, aiming for complete thyroid ablation with a personalized RAI activity. We recommend avoiding RAI in children under 10 years of age but favor surgery in patients with large goiter. Pediatric endocrinologists should be involved in all cases. Bioscientifica Ltd 2021-11-04 /pmc/articles/PMC9142815/ /pubmed/34981748 http://dx.doi.org/10.1530/ETJ-21-0073 Text en © European Thyroid Association https://creativecommons.org/licenses/by-nc-nd/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Guidelines Mooij, Christiaan F Cheetham, Timothy D Verburg, Frederik A Eckstein, Anja Pearce, Simon H Léger, Juliane van Trotsenburg, A S Paul 2022 European Thyroid Association Guideline for the management of pediatric Graves’ disease |
title | 2022 European Thyroid Association Guideline for the management of pediatric Graves’ disease |
title_full | 2022 European Thyroid Association Guideline for the management of pediatric Graves’ disease |
title_fullStr | 2022 European Thyroid Association Guideline for the management of pediatric Graves’ disease |
title_full_unstemmed | 2022 European Thyroid Association Guideline for the management of pediatric Graves’ disease |
title_short | 2022 European Thyroid Association Guideline for the management of pediatric Graves’ disease |
title_sort | 2022 european thyroid association guideline for the management of pediatric graves’ disease |
topic | Guidelines |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9142815/ https://www.ncbi.nlm.nih.gov/pubmed/34981748 http://dx.doi.org/10.1530/ETJ-21-0073 |
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