Background: Graves’ disease (GD) is the most common cause of hyperthyroidism in children and adolescents. Treatments
consist of medication, radioactive iodine (RAI) therapy and surgery. Currently, radioactive iodine therapy is the first line
treatment in many medical centers.
Objective: To evaluate the effectiveness and safety of RAI therapy in childhood GD.
Material and Method: A retrospective study was performed in 46 GD patients, aged at onset <15 years, who had undergone
RAI therapy at the age >10 years. Goiter grading, evidence of hypothyroidism, severity of ophthalmopathy, RAI dosage and
side effects of RAI therapy were evaluated.
Results: The cure rate was 95.6%. All participating patients had goiter reduction (p = 0.005). Hypothyroidism was induced
in 33 (71.7%) and 11 (23.9%) patients after the first and second RAI therapy. The total RAI dosage was significantly higher in the patients with failure response (p = 0.001). The average time to induce hypothyroidism after the first RAI therapy was 127.5 (IQR: 94.5-223.0) days. All of the patients had improvement of ophthalmopathy and none had thyroid carcinoma during the follow-up period of 42.5 (IQR: 17-52) months.
Conclusion: Radioactive iodine therapy is effective and safe in the treatment of children and adolescents with Graves’
disease.

Keywords: Graves’ disease, Radioiodine therapy, Childhood, Adolescent