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The natural history and prognostic factors of Graves' disease in Korean children and adolescents

Korean Journal of Pediatrics 2010;53(4):585-591.
Published online April 15, 2010.
The natural history and prognostic factors of Graves' disease in Korean children and adolescents
Seung Min Song1, Ji-Seok Youn1, Jung Min Ko2, Chong Kun Cheon3, Jin-Ho Choi1, Han Wook Yoo1
1Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
2Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
3Department of Pediatrics, College of Medicine, Pusan National University, Busan, Korea
한국 소아 및 청소년 Graves병의 자연 경과 및 예후 인자
송승민1, 윤지석1, 고정민2, 전종근3, 최진호1, 유한욱1
1울산대학교 의과대학 서울아산병원 소아청소년과
2아주대학교 의과대학 소아과학교실
3부산대학교 의과대학 소아과학교실
Correspondence: 
Han Wook Yoo, Email: hwyoo@amc.seoul.kr
Abstract
Purpose
: Graves' disease is the most common cause of hyperthyroidism in children and adolescents. In this study, we investigated the natural course and the prognostic factors of Graves' disease in Korean children and adolescents.
Methods
: One-hundred thirteen (88 girls and 25 boys) patients were included in this study. A retrospective analysis was made of all patients who were diagnosed with Graves' disease. The following parameters were recorded and analyzed: patient's sex, age at diagnosis, duration of disease, laboratory findings, symptoms and signs, and family history of autoimmune thyroid disease.
Results
: All patients were initially treated with antithyroid drugs, either methimazole (93.8%) or propylthiouracil (6.2%). Antithyroid drugs had been discontinued in 75 (66.4%) of 113 patients. Of these 75 patients, 23 (20.4%) relapsed after 25.5¡¾33.7 months. Thirteen (11.5%) of 23 patients, who experienced the first relapse, showed a second remission. However, 2 (1.8%) of 13 patients relapsed again. Euthyroid state could not be achieved by antithyroid drugs in 1 patient, and radioactive iodine therapy was performed. The older the patient at diagnosis, the greater the likelihood of remission (P =0.034).
Conclusion
: Age at diagnosis seems to be a prognostic factor in Korean children and adolescents with Graves' disease, and should be taken into account in treatment plan determination.
Key Words: Graves' disease, Natural course, Prognostic factor


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