Time course to hypothyroidism after fixed-dose radioablation therapy of Graves' disease in children

J Pediatr. 2002 Jul;141(1):99-103. doi: 10.1067/mpd.2002.125494.

Abstract

Objective: To characterize the development of hypothyroidism in pediatric patients who receive a fixed dose of radioactive iodine (RAI).

Study design: Medical records of children treated with fixed-dose RAI for Graves'disease between 1993 and 2001 were reviewed. Multiple variables including sex, age, thyroid hormone levels, thyroid-stimulating immunoglobulin titer, antithyroid medication use, and 24-hour radioiodine uptake were investigated as possible predictive factors for the development of hypothyroidism after treatment. All patients received RAI at a dose of between 13.8 and 15.6 mCi (average, 14.7 mCi; SD, 0.5).

Results: Permanent hypothyroidism developed in all 40 patients, although a second dose of RAI was required in one case. The average time to hypothyroidism was 77 days (SD, 32), with a range of 28 to 194 days; 75% of the patients were diagnosed with hypothyroidism between 40 and 90 days. RAI treatment was ineffective in an additional patient, who required subtotal thyroidectomy.

Conclusions: We conclude that a fixed dose of RAI is effective therapy in nearly all pediatric patients with Graves'disease. Factors predicting the time course to hypothyroidism were not identified.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Graves Disease / radiotherapy*
  • Humans
  • Hypothyroidism / epidemiology*
  • Hypothyroidism / etiology
  • Indiana / epidemiology
  • Iodine Radioisotopes / administration & dosage*
  • Male
  • Radiotherapy Dosage
  • Retrospective Studies
  • Statistics, Nonparametric
  • Time Factors

Substances

  • Iodine Radioisotopes