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Efficacy and safety of radioiodine treatment of Graves’ disease in children and adolescents

Abstract

There are three methods in treatment of Graves’ disease in children and adolescents – antithyroid drugs, surgery and radioiodine therapy (RIT). However, treatment protocol of children and adolescents doesn’t exist. In the present case series study we have evaluated the effectiveness and safety of RIT in children and adolescents. We have observed totally 25 patients in age 11–17 years old (mean 14.8 years) with Graves’ disease. Ten patients were treated with RIT in Endocrinology Research Centre (Moscow) in 2016 year with activities 550–920 MBq. Follow-up period varied 6–11 months in this subgroup. The second subgroup (15 patients) was treated in radiology department in Nijniy Tagil rural hospital (Ural region) in the period 2005–2012 years. Follow-up period varied 3.5–11.5 years (mean 8.5 years). RIT was executed in all patients without any complications, direct or long-term. In two patients having endocrine ophtalmopathy in non-active phase it was no any signs of worsening in result of RIT. In 17 (68%) of 25 patients the hypothyroidism occurred through 6 months. In one case – euthyroidism. In remain 7 observations the hyperthyroidism recurred. Patient subgroups didn’t differ in mean age, gender ratio, thyroid size and autoantibodies to TSH receptor levels, but were differed in treatment 131I activities (subset from ERC – 550–920 MBq; subset from Nijniy Tagil – 168–400 MBq). However the treatment efficacy did not differ significantly (p = 0.99): 68% and 73%, accordingly. In conclusion, RIT of Graves’ disease in a safe and effective method of treatment for hyperthyroidism in children and adolescents. It’s necessary to prolong study in numerous patients cohort, longer-lasting follow-up period as well as to improve RIT efficiency.

About the Authors

Pavel O. Rumiantsev

Endocrinology Research Centre


Russian Federation

MD, PhD


Competing Interests:

No conflict of interests.



Marina S. Sheremeta

Endocrinology Research Centre


Russian Federation

MD, PhD


Competing Interests:

No conflict of interests.



Alexey V. Kiyaev

Ural’s State Medical University


Russian Federation

MD, MhD, Professor


Competing Interests:

No conflict of interests.



Luydmila A. Kurmyshova

Radiological Centre of the Hospital №4


Russian Federation

MD


Competing Interests:

No conflict of interests.



Olga A. Chikulaeva

Endocrinology Research Centre


Russian Federation

MD, PhD, leading research associate


Competing Interests:

No conflicts of interest.



References

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Supplementary files

1. Таблица 1. Динамика тиреоидной функции в течение 6 мес после проведения РЙТ
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Type Исследовательские инструменты
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2. Таблица 2. Лечебная активность 131I и тиреоидный статус через 6 мес после РЙТ
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Type Исследовательские инструменты
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3. Таблица 3. Изменение объема ЩЖ через 6 мес после РЙТ
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Type Исследовательские инструменты
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4. Таблица 4. Изменение объема ЩЖ через 6 мес после РЙТ в группе больных с гипотиреозом и отсутствием такового
Subject
Type Исследовательские инструменты
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5. Рис. 1. Динамика объема ЩЖ (мл) до и через 6 мес после РЙТ.
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Type Исследовательские инструменты
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6. Рис. 2. Удельная активность (МБк/мл) 131I и эффект лечения.
Subject
Type Исследовательские инструменты
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7. Рис. 3. Суммарная доза облучения щитовидной железы (Гр) и РЙТ.
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Type Исследовательские инструменты
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8. Таблица 5. Сопоставление параметров групп детей и подростков с ДТЗ, получивших РЙТ и наблюдающихся в ЭНЦ (2016 г.) и в Нижнем Тагиле (2005–2012 гг.)
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Type Исследовательские инструменты
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Review

For citations:


Rumiantsev P.O., Sheremeta M.S., Kiyaev A.V., Kurmyshova L.A., Chikulaeva O.A. Efficacy and safety of radioiodine treatment of Graves’ disease in children and adolescents. Clinical and experimental thyroidology. 2017;13(1):6-11. (In Russ.)

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ISSN 1995-5472 (Print)
ISSN 2310-3787 (Online)