ISSN: 1308-5727 | E-ISSN: 1308-5735
Volume : Issue : Year : 2024
Forms

Abstracting & Indexing
Turkish Society for Pediatric Endocrinology and Diabetes
Management of Thyrotoxicosis in Children and Adolescents: A Turkish Multi-center Experience [J Clin Res Pediatr Endocrinol]
J Clin Res Pediatr Endocrinol. 2019; 11(2): 164-172 | DOI: 10.4274/jcrpe.galenos.2018.2018.0210

Management of Thyrotoxicosis in Children and Adolescents: A Turkish Multi-center Experience

İhsan Esen1, Elvan Bayramoğlu2, Melek Yıldız3, Murat Aydın4, Esin Karakılıç Özturhan5, Zehra Aycan2, Semih Bolu6, Hasan Önal3, Yılmaz Kör7, Deniz Ökdemir1, Edip Ünal8, Aşan Önder9, Olcay Evliyaoğlu10, Atilla Çayır11, Mehmet Taştan12, Ayşegül Yüksel13, Aylin Kılınç14, Muammer Büyükinan15, Bahar Özcabı16, Onur Akın17, Çiğdem Binay18, Suna Kılınç19, Ruken Yıldırım20, Emel Hatun Aytaç21, Elif Sağsak22
1Fırat University Faculty of Medicine, Department of Pediatric Endocrinology, Elazığ, Turkey
2Dr. Sami Ulus Maternity and Children’s Disease Training and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey
3Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
4Ondokuz Mayıs University Faculty of Medicine, Department of Pediatric Endocrinology, Samsun, Turkey
5İstanbul University İstanbul Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
6Düzce University Faculty of Medicine, Department of Pediatric Endocrinology, Düzce, Turkey
7Adana City Hospital, Clinic of Pediatric Endocrinology, Adana, Turkey
8Dicle University Faculty of Medicine, Department of Pediatric Endocrinology, Diyarbakır, Turkey
9Göztepe Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
10İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
11Erzurum Bölge Training and Research Hospital, Clinic of Pediatric Endocrinology, Erzurum, Turkey
12Çukurova University Faculty of Medicine, Department of Pediatric Endocrinology, Adana, Turkey
13Derince Training and Research Hospital, Clinic of Pediatric Endocrinology, Kocaeli, Turkey
14Gazi University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
15Konya Training and Research Hospital, Clinic of Pediatric Endocrinology, Konya, Turkey
16Zeynep Kamil Maternity and Children’s Disease Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
17Gülhane Training and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey
18Çorlu State Hospital, Clinic of Pediatric Endocrinology, Tekirdağ, Turkey
19Bağcılar Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
20Diyarbakır Pediatric Hospital, Clinic of Pediatric Endocrinology, Diyarbakır, Turkey
21Gaziantep University Faculty of Medicine, Department of Pediatric Endocrinology, Gaziantep, Turkey
22Gaziosmanpaşa Taksim Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey

Objective: To determine the demographic and biochemical features of childhood and juvenile thyrotoxicosis and treatment outcome.
Methods: We reviewed the records of children from 22 centers in Turkey who were diagnosed with thyrotoxicosis between 2007 to 2017.
Results: A total of 503 children had been diagnosed with thyrotoxicosis at the centers during the study period. Of these, 375 (74.6%) had been diagnosed with Graves’ disease (GD), 75 (14.9%) with hashitoxicosis and 53 (10.5%) with other less common causes of thyrotoxicosis. The most common presenting features in children with GD or hashitoxicosis were tachycardia and/or palpitations, weight loss and excessive sweating. The cumulative remission rate was 17.6% in 370 patients with GD who had received anti-thyroid drugs (ATDs) for initial treatment. The median (range) treatment period was 22.8 (0.3-127) months. No variables predictive of achieving remission were identified. Twenty-seven received second-line treatment because of poor disease control and/or adverse events associated with ATDs. Total thyroidectomy was performed in 17 patients with no recurrence of thyrotoxicosis and all became hypothyroid. Ten patients received radioiodine and six became hypothyroid, one remained hyperthyroid and restarted ATDs and one patient achieved remission. Two patients were lost to follow up.
Conclusion: This study has demonstrated that using ATDs is the generally accepted first-line approach and there seems to be low remission rate with ATDs in pediatric GD patients in Turkey.

Keywords: Graves’ disease, hashitoxicosis, thyrotoxicosis, antithyroid drug, radioactive iodine, total thyroidectomy

İhsan Esen, Elvan Bayramoğlu, Melek Yıldız, Murat Aydın, Esin Karakılıç Özturhan, Zehra Aycan, Semih Bolu, Hasan Önal, Yılmaz Kör, Deniz Ökdemir, Edip Ünal, Aşan Önder, Olcay Evliyaoğlu, Atilla Çayır, Mehmet Taştan, Ayşegül Yüksel, Aylin Kılınç, Muammer Büyükinan, Bahar Özcabı, Onur Akın, Çiğdem Binay, Suna Kılınç, Ruken Yıldırım, Emel Hatun Aytaç, Elif Sağsak. Management of Thyrotoxicosis in Children and Adolescents: A Turkish Multi-center Experience. J Clin Res Pediatr Endocrinol. 2019; 11(2): 164-172
Manuscript Language: English
LookUs & Online Makale