All issues > Volume 38(10); 1995

Original Article

J Korean Pediatr Soc. 1995;38(10):1404-1410. Published online October 15, 1995.

The Changes of Thyroid Function Tests and TSH Receptor Antibody Levels During Antithyroid Drug Therapy of Graves Disease in Children

Jeong-Ho JH Kim¹, Eun-Young EY Cho¹, Han-Wook HW Yoo¹

¹Department of Pediatrics, Ulsan University, College of Medicine, Seoul, Korea

Abstract

The mainstay of treatment in children with Graves' disease is antithyroid drug therapy. Most commonly used drugs are methimazole(MMI) and propylthiuracil(PTU). These drugs inhibit thyroid hormone synthesis through mechanisms that interfere with the action of thyroid peroxidase. Since antithyroid drugs are unable to inhigit the secretion of thyroid hormone which is already produced, it takes 2 to 3 weeks for apparent clinical response and 1 to 3 months to normalize thyroid function. In this study, we compared the effect of methimazole and PTU by sequential measurements of thyroid fuctions and TBII levels in 22 patients with Graves disease who were dignosed at the Department of Pediatrics, Asan Medical Center from July 1989 through June 1994. The patients were divided into two groups. One group included 13 patients who were treated with MMI and the other group had 9 patients who were treated with PTU. Pretreated thyroid functions. TBII level were not statistically different between both groups. Treatment duration befor normalization of thyroid functions between both groups, were (MMI treatment group versus PTU group) : T4, 1.3¡¾0.2 months : 1.9¡¾0.3 months, T3 2.1¡¾0.3 months : 3.3¡¾0.6 months, TSH, 2.8¡¾0.3 months : 4.3¡¾0.8 months, and TBII, 13.4¡¾2.4 months : 9.3¡¾6.3 months. There was no statistical differences in both groups as to durations for normalization of thyroid function tests. However, T4, T3, TSH, and TBII were normalized in order. Complete remission was achieved in one case treated with MMI, while each group had one medical treatment failure. Aforementioned results suggest that there is no difference in the effect of MMI vs PTU, though the larger scaled prospective study is needed. In addition, the finding that it takes 1 to 2 month for T4, 2 to 3 months for T3, 3 to 4 months for TSH and 1 year for TBII to be normalized, should be considered during follow up.

Keywords :Graves disease, Antithyroid drug effects, Thyroid function follow up