Barnes H V, Blizzard R M
J Pediatr. 1977 Aug;91(2):313-20. doi: 10.1016/s0022-3476(77)80843-3.
Since 1946 104 children and adolescents with toxic diffuse goiter have been treated. Sixty-seven were treated with a thioamide for more than 12 months. Remission occurred in 61%. Twenty-five patients had a 12-hour perchlorate discharge test to determine the least frequent dose schedule required for disease control: 68% could be controlled on a single daily dose and an additional 25% on an every 12-hour schedule. A one-hour radioiodine uptake on combined therapy and change in thyroid gland size during treatment were found to be highly correlated with the presence of a spontaneous remission. Thirty-six patients have been treated by subtotal thyroidectomy. To date 65% have developed permanent hypothyroidism. In the author's opinion, thoamides are the treatment of choice for the majority of children and adolescents.
自1946年以来，已对104例儿童和青少年毒性弥漫性甲状腺肿患者进行了治疗。67例患者接受硫酰胺治疗超过12个月。缓解率为61%。25例患者进行了12小时高氯酸盐释放试验，以确定控制疾病所需的最低给药频率：68%的患者每日单次给药即可控制，另外25%的患者每12小时给药一次。联合治疗时1小时放射性碘摄取率和治疗期间甲状腺大小的变化与自发缓解的存在高度相关。36例患者接受了甲状腺次全切除术。迄今为止，65%的患者出现了永久性甲状腺功能减退。作者认为，硫酰胺是大多数儿童和青少年的首选治疗方法。
