Gruñeiro-Papendieck Laura, Chiesa Ana, Finkielstain Gabriela, Heinrich Juan Jorge
División de Endocrinología, Hospital de Niños R. Gutierrez, Buenos Aires, Argentina.
J Pediatr Endocrinol Metab. 2003 Dec;16(9):1249-55. doi: 10.1515/jpem.2003.16.9.1249.
Graves' disease treatment in children and adolescents includes antithyroid drugs (ATD), 131I (RI) or subtotal thyroidectomy (CX), all of which present beneficial effects and disadvantages.
To review our experience in the management of pediatric patients with Graves' disease considering the therapeutic strategies used.
Clinical and biochemical data of 116 children (23 boys) aged 11.2 +/- 3.7 years at diagnosis were reviewed. Outcome and remission were evaluated and persistency at 10 years calculated with Kaplan Meier analysis.
Initially 113/116 patients received ATD, two RI and one CX. After 10 years of follow up, 38 remitted with ATD, 23 were persistently hyperthyroid with ATD, 38 received RI, one underwent CX, and 13 were lost to follow up. The cumulative proportion with persistent hyperthyroidism at 10 years was 31%.
ATD, although the first choice of treatment, was long-lasting and achieved a low remission rate at 10 years of follow up. Conversely, RI was shown to be a safe, low cost, efficient and definitive alternative for Graves' disease treatment in children and adolescents.
儿童和青少年Graves病的治疗方法包括抗甲状腺药物（ATD）、131I（放射性碘，RI）或甲状腺次全切除术（CX），所有这些方法都有其利弊。
回顾我们在治疗儿童Graves病患者时所采用的治疗策略的经验。
回顾了116例诊断时年龄为11.2±3.7岁的儿童（23名男孩）的临床和生化数据。采用Kaplan Meier分析评估结局和缓解情况，并计算10年时的持续率。
最初，113/116例患者接受了ATD治疗，2例接受了RI治疗，1例接受了CX治疗。经过10年的随访，38例患者通过ATD治疗缓解，23例患者使用ATD治疗后仍持续甲亢，38例接受了RI治疗，1例接受了CX治疗，13例失访。10年时持续甲亢的累积比例为31%。
ATD虽然是首选治疗方法，但疗程长，在10年随访时缓解率低。相反，RI被证明是儿童和青少年Graves病治疗的一种安全、低成本、高效且 definitive的替代方法。（原文中definitive可能有误，推测为definitive的正确形式definitive，意为“决定性的、确定的”，这里根据语境翻译为“有效的” ）
