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Clinical Study of Graves` Diseasein Children : Remission and Relaps

Journal of the Korean Pediatric Society 1996;39(3):389-396.
Published online March 15, 1996.
Clinical Study of Graves` Diseasein Children : Remission and Relaps
Moon Young Song, Bin Cho, Byung Churl Lee
Department of Pediatrics, Catholic University Medical College, Seoul, Korea
소아 Graves병의 임상적 고찰 :관해와 재발
송문영, 조빈, 이병철
가톨릭대학교 의과대학 소아과학교실
Abstract
Purpose
: This study was carried out to evaluate the age and sex distribution, clinical manifestation, presence of the antithyroid antibody, the clinical outcome following antithyroid drug treatment in children with Graves' disease.
Methods
: A total 45 children with Graves' disease were entered into the study. Diagnosis was based on clinical manifestation, elevated thyroid function and increased homogeneous 99mTc thyroid uptake on thyroid scan. All patient were treated with prophylthiouracil or methimazole, and assessed concerning about clinical symptoms and signs, existence of antithyroid antibody and states of thyroid function and outcome following antithyroid drug treatment during 3 years of therapy. Remission was defined as a euthyroid state without clinical manifestation and presence of TRAb, while relapse was defined as the recurrence of hyperthyroidism within 12 months of no medication after antithyroid therapy at least for 3 years.
Results
: 1) The most prevalent age group was 10 to 15 years(82.8%) and female is more prevalent than male(M : F=1 : 14). 2) Goiter, emotional instability, hyperactivity, palpitation, sweating and exophthalmos are the most common symptoms in orders. 3) The detection rate of TRAb, AMA and ATA before treatment were 93.3%, 86.7% and 62.2% respectively. 4) The euthyroid state showed in 36(80.0%) of 45 patients within 8 weeks after treatment. 5) The TRAb values remained positive in 27(60.0%) of 45 patients during the first 1 year of antithyroid therapy. 6) Remission rate was 58.8%(26 cases) and relapse rate of remission cases 73.1%.
Conclusion
: The present study suggests that children with Graves' disease will continue to require long term clinical and laboratory assessment after discontinuation of antithyroid drug therapy.
Key Words: Graves` disease, Remission, Relapse


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