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Remission in Children With Hyperthyroidism Treated With Propylthiouracil: Long-term Results

Remission in Children With Hyperthyroidism Treated With Propylthiouracil: Long-term Results Abstract • We treated 69 hyperthyroid children with propylthiouracil, of whom 53 remained under surveillance. Of these children, 34 (64%) had an Initial remission, but relapses were frequent (47%). At this writing, 24 patients (45%) were in remission, with a mean duration of remission of 55 months (range, ten to 132 months). We found that the triiodothyronine level took significantly longer than the thyroxine (T4) level to return to normal. Thus, based on the T4 level alone, treatment may have been stopped prematurely in some patients, causing the relapse rate to be falsely high. The response to therapy did not depend on the size of the goiter nor on the Initial levels of T4 or triiodothyronine. Six patients had adverse reactions, which were serious in two patients. (AJDC 1987;141:1084-1086) References 1. Becker DV: Choice of therapy for Graves' hyperthyroidism . N Engl J Med 1984;311: 464-466.Crossref 2. Ingbar SH: The thyroid gland , in Wilson JD, Foster DW (eds): Textbook of Endocrinology , ed 7. Philadelphia, WB Saunders Co, 1985, pp 682-815. 3. Merchant B, Brownlie BEW, Hart D, et al: The placental transfer of propylthiouracil, methimazole and carbimazole . J Clin Endocrinol Metab 1977;45:1187-1193.Crossref 4. Burrow GN: Hyperthyroidism during pregnancy . N Engl J Med 1978;298:150-153.Crossref 5. Hamburger JI: Management of hyperthyroidism in children and adolescents . J Clin Endocrinol Metab 1985;60:1019-1024.Crossref 6. Hayles AB: Problems of childhood Graves' disease . Mayo Clin Proc 1972;47:850-853. 7. Sridama V, McCormick M, Kaplan EL, et al: Long-term follow-up study of compensated low dose 1131 therapy for Graves' disease . N Engl J Med 1984;311:426-432.Crossref 8. Vaidya VA, Bongiovanni AM, Parks JS, et al: Twenty-two years' experience in the medical management of juvenile thyrotoxicosis . Pediatrics 1974;54:565-570. 9. Barnes HV, Blizzard RM: Anti-thyroid drug therapy for toxic diffuse goiter (Graves disease): Thirty years' experience in children and adolescents . J Pediatr 1977;91:313-320.Crossref 10. Collen RJ, Landaw EM, Kaplan SA, et al: Remission rates of children and adolescents with thyrotoxicosis treated with antithyroid drugs . Pediatrics 1980;65:550-556. 11. Dunn JT: Choice of therapy in young adults with hyperthyroidism of Graves' disease . Ann Intern Med 1984;100:891-893.Crossref 12. Farnell MB, van Heerden JA, McConahey WM, et al: Hypothyroidism after thyroidectomy for Graves' disease . Am J Surg 1981;142:535-538.Crossref 13. Haynes RC Jr, Murad F: Thyroid and antithyroid drugs , in Gilman AG, Goodman LS, Rall TW, et al (eds): The Pharmacological Basis of Therapeutics , ed 7. New York, Macmillan Publishing Co, 1985, pp 1389-1411. 14. Takamatsu J, Kuma K, Mozai T: Serum triiodothyronine to thyroxine ratio: A newly recognized predictor of the outcome of hyper thyroidism due to Graves' disease . J Clin Endocrinol Metab 1986;62:980-983.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Remission in Children With Hyperthyroidism Treated With Propylthiouracil: Long-term Results

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Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1987.04460100062026
Publisher site
See Article on Publisher Site

Abstract

Abstract • We treated 69 hyperthyroid children with propylthiouracil, of whom 53 remained under surveillance. Of these children, 34 (64%) had an Initial remission, but relapses were frequent (47%). At this writing, 24 patients (45%) were in remission, with a mean duration of remission of 55 months (range, ten to 132 months). We found that the triiodothyronine level took significantly longer than the thyroxine (T4) level to return to normal. Thus, based on the T4 level alone, treatment may have been stopped prematurely in some patients, causing the relapse rate to be falsely high. The response to therapy did not depend on the size of the goiter nor on the Initial levels of T4 or triiodothyronine. Six patients had adverse reactions, which were serious in two patients. (AJDC 1987;141:1084-1086) References 1. Becker DV: Choice of therapy for Graves' hyperthyroidism . N Engl J Med 1984;311: 464-466.Crossref 2. Ingbar SH: The thyroid gland , in Wilson JD, Foster DW (eds): Textbook of Endocrinology , ed 7. Philadelphia, WB Saunders Co, 1985, pp 682-815. 3. Merchant B, Brownlie BEW, Hart D, et al: The placental transfer of propylthiouracil, methimazole and carbimazole . J Clin Endocrinol Metab 1977;45:1187-1193.Crossref 4. Burrow GN: Hyperthyroidism during pregnancy . N Engl J Med 1978;298:150-153.Crossref 5. Hamburger JI: Management of hyperthyroidism in children and adolescents . J Clin Endocrinol Metab 1985;60:1019-1024.Crossref 6. Hayles AB: Problems of childhood Graves' disease . Mayo Clin Proc 1972;47:850-853. 7. Sridama V, McCormick M, Kaplan EL, et al: Long-term follow-up study of compensated low dose 1131 therapy for Graves' disease . N Engl J Med 1984;311:426-432.Crossref 8. Vaidya VA, Bongiovanni AM, Parks JS, et al: Twenty-two years' experience in the medical management of juvenile thyrotoxicosis . Pediatrics 1974;54:565-570. 9. Barnes HV, Blizzard RM: Anti-thyroid drug therapy for toxic diffuse goiter (Graves disease): Thirty years' experience in children and adolescents . J Pediatr 1977;91:313-320.Crossref 10. Collen RJ, Landaw EM, Kaplan SA, et al: Remission rates of children and adolescents with thyrotoxicosis treated with antithyroid drugs . Pediatrics 1980;65:550-556. 11. Dunn JT: Choice of therapy in young adults with hyperthyroidism of Graves' disease . Ann Intern Med 1984;100:891-893.Crossref 12. Farnell MB, van Heerden JA, McConahey WM, et al: Hypothyroidism after thyroidectomy for Graves' disease . Am J Surg 1981;142:535-538.Crossref 13. Haynes RC Jr, Murad F: Thyroid and antithyroid drugs , in Gilman AG, Goodman LS, Rall TW, et al (eds): The Pharmacological Basis of Therapeutics , ed 7. New York, Macmillan Publishing Co, 1985, pp 1389-1411. 14. Takamatsu J, Kuma K, Mozai T: Serum triiodothyronine to thyroxine ratio: A newly recognized predictor of the outcome of hyper thyroidism due to Graves' disease . J Clin Endocrinol Metab 1986;62:980-983.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Oct 1, 1987

References