All issues > Volume 53(4); 2010

Original Article

Korean J Pediatr. 2010;53(4):585-591. Published online April 15, 2010.

The natural history and prognostic factors of Graves' disease in Korean children and adolescents

Seung Min SM Song¹, Ji-Seok JS Youn¹, Jung Min JM Ko², Chong Kun CK Cheon³, Jin-Ho JH Choi¹, Han Wook HW Yoo¹

¹Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
²Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
³Department of Pediatrics, College of Medicine, Pusan National University, Busan, Korea

Correspondence Han Wook HW Yoo ,Email: hwyoo@amc.seoul.kr

Abstract

Purpose
: Graves' disease is the most common cause of hyperthyroidism in children and adolescents. In this study, we investigated the natural course and the prognostic factors of Graves' disease in Korean children and adolescents.
Methods
: One-hundred thirteen (88 girls and 25 boys) patients were included in this study. A retrospective analysis was made of all patients who were diagnosed with Graves' disease. The following parameters were recorded and analyzed: patient's sex, age at diagnosis, duration of disease, laboratory findings, symptoms and signs, and family history of autoimmune thyroid disease.
Results
: All patients were initially treated with antithyroid drugs, either methimazole (93.8%) or propylthiouracil (6.2%). Antithyroid drugs had been discontinued in 75 (66.4%) of 113 patients. Of these 75 patients, 23 (20.4%) relapsed after 25.5¡¾33.7 months. Thirteen (11.5%) of 23 patients, who experienced the first relapse, showed a second remission. However, 2 (1.8%) of 13 patients relapsed again. Euthyroid state could not be achieved by antithyroid drugs in 1 patient, and radioactive iodine therapy was performed. The older the patient at diagnosis, the greater the likelihood of remission (P =0.034).
Conclusion
: Age at diagnosis seems to be a prognostic factor in Korean children and adolescents with Graves' disease, and should be taken into account in treatment plan determination.

Keywords :Graves' disease, Natural course, Prognostic factor