Translational and Clinical Research Institute, Newcastle University, Newcastle-Upon-Tyne, UK.
Department of Paediatric Endocrinology, The Great North Children's Hospital, Newcastle-Upon-Tyne, UK.
Expert Rev Endocrinol Metab. 2020 Mar;15(2):59-69. doi: 10.1080/17446651.2020.1735359. Epub 2020 Mar 5.
: First-line treatment for most young people with Graves' disease (GD) will include the administration of a thionamide antithyroid medication (ATD); Carbimazole (CBZ), Methimazole (MMZ), or rarely, propylthiouracil (PTU). GD is a challenge for families and clinicians because the likelihood of remission following a course of ATD is lower in young people when compared to adults, yet the risk of adverse events is higher. An overall consensus regarding the optimal ATD treatment regimen is lacking; how ATD are prescribed, for how long and how the associated risk of adverse events is managed varies between clinicians, units and nations. This partly reflects clinician and family uncertainty regarding outcomes.: This review will focus on some of the key articles published in the field of thionamide ATD in children. It will highlight key issues that need to be discussed with families as well as addressing the approach and controversies in the treatment of GD. This article does not reflect a formal systematic review of the literature.: New strategies in areas such as immunomodulation may see the development of new antithyroid drug treatments that, either in isolation or in combination with thionamide therapy, may increase the likelihood of long-term remission.
: 大多数格雷夫斯病（GD）的年轻人的一线治疗将包括使用硫酰胺类抗甲状腺药物（ATD）；卡比马唑（CBZ）、甲巯咪唑（MMZ），或很少使用丙基硫氧嘧啶（PTU）。GD 对家庭和临床医生来说是一个挑战，因为与成年人相比，年轻人在接受 ATD 治疗后缓解的可能性较低，但不良事件的风险更高。目前缺乏关于最佳 ATD 治疗方案的总体共识；ATD 的使用方式、使用时间以及如何管理相关的不良事件风险在临床医生、单位和国家之间存在差异。这在一定程度上反映了临床医生和家庭对结果的不确定性。: 这篇综述将重点介绍儿童硫酰胺 ATD 领域发表的一些关键文章。它将强调需要与家庭讨论的关键问题，并探讨 GD 的治疗方法和争议。本文并没有对文献进行正式的系统综述。: 在免疫调节等领域的新策略可能会开发出新的抗甲状腺药物治疗方法，这些方法无论是单独使用还是与硫酰胺治疗联合使用，都可能增加长期缓解的可能性。
