Effectiveness and Safety of Radioactive Iodine Therapy in Childhood Graves’ Disease in Khon Kaen, Thailand
Songpon Getsuwan MD*, Pattara Wiromrat MD*, Ouyporn Panamonta MD*, Manat Panamonta MD*, Sunphat Paireepinas MD**
Affiliation : * Department of Pediatrics, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand ** Division of Nuclear Radiology, Department of Radiology, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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
