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Clinical features at diagnosis and responses to antithyroid drugs in younger children with Graves’ disease compared with adolescent patients

  • Hirokazu Sato EMAIL logo , Kanshi Minamitani , Masanori Minagawa , Itsuro Kazukawa , Shigetaka Sugihara , Kunio Wataki , Susumu Konda , Hiroaki Inomata , Kazunori Sanayama , Yoichi Kohno and Nozomu Sasaki
Published/Copyright: April 16, 2014
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 27 Issue 7-8

Abstract

Objective: The aim of this study was to evaluate clinical manifestations, laboratory findings, and effects of antithyroid drugs in younger children with Graves’ disease (GD).

Design: A retrospective and collaborative study.

Setting: Nine facilities in Chiba prefecture, Japan.

Patients: We analyzed 132 children and adolescents with GD. The subjects were divided according to the median age into a group of young children (group I, 4.1–12.4 years, n=66) and an adolescent group (group II, 12.5–15.9 years, n=66).

Main outcome measures: Clinical manifestations, laboratory findings, incidence of adverse effects, and remission rates 5 years after initial therapy were assessed.

Results: The mean height SD score of group I (1.0) was higher than that of group II (0.3, p<0.001). The mean BMI SD score of group I (–0.7) was lower than that of group II (–0.3, p<0.05). The most common presentations were goiter, sweating, and hyperactivity in group I, whereas the most common presentations were goiter, sweating, and easy fatigability in group II. Hyperactivity was more frequent in group I (56.7%) than in group II (37.9%, p<0.05). Liver dysfunction appeared more often in group I (14.3%) than in group II (1.9%, p<0.05). There was no difference in the appearance of adverse effects between the two groups. The remission rate was slightly lower in group I (23.1%) than in group II (31.3%), but was not significant.

Conclusions: Thyrotoxicosis had more influence on the growth and liver function in younger children.

Keywords: adolescence; Graves’ disease; growth; outcome; younger children
Corresponding author: Hirokazu Sato MD, Sunrise Children’s Clinic, Nakayama Medical Square 1F, 4-22-10 Motonakayama, Funabashi, Chiba 273-0035, Japan, Phone: +81-47-333-8222, Fax: +81-47-333-2733, E-mail:
aH. Sato performed the statistical analysis and wrote the first draft of the manuscript, and the other authors are collaborating researchers.

Acknowledgments

We are indebted to the honorary professor of Chiba University, Hironori Nakajima, for finding our group for clinical research on pediatric endocrinology; the honorary professor of Chiba University, Hiroo Niimi, for subsequent development of the group; Dr. Toshiaki Tsuyusaki and Dr. Kiyoe Tamaru for their investigation of Graves’ disease in the group; and all physicians in each facility for their cooperation with the study.

Conflict of interest statement: The authors have no conflict of interest to declare.

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Received: 2013-7-7
Accepted: 2014-2-28
Published Online: 2014-4-16
Published in Print: 2014-7-1

©2014 by Walter de Gruyter Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Welcome to Assistant Editors at JPEM
  4. Review article
  5. Common approach to childhood obesity in Japan
  6. Images in pediatric endocrinology
  7. Aromatase deficiency in an adolescent girl misdiagnosed as congenital adrenal hyperplasia in infancy and childhood
  8. Original articles
  9. Prevalence of vitamin D deficiency among Iranian adolescents
  10. Analysis of body composition among children and adolescents – a cross-sectional study of the Polish population and comparison of body fat measurement methods
  11. Association of rs8066560 variant in the sterol regulatory element-binding protein 1 (SREBP-1) and miR-33b genes with hyperglycemia and insulin resistance
  12. Differences in anxiety and depression between male and female caregivers of children with a disorder of sex development
  13. Fasting and postprandial levels of a novel anorexigenic peptide nesfatin in childhood obesity
  14. The effect of growth hormone treatment on height in children with idiopathic short stature
  15. Clinical characteristics of type 1 diabetes over a 40 year period in Turkey: secular trend towards earlier age of onset
  16. Relationships of gamma-glutamyltransferase and beta 2-microglobulin on high sensitivity C-reactive protein among Japanese elementary school children
  17. Evaluation of insulin resistance and metabolic syndrome in a group of obese Czech children
  18. Circulating intact parathyroid hormone is suppressed at 25-hydroxyvitamin D concentrations >25 nmol/L in children
  19. Association between vitamin D level and cardiovascular risk in obese children and adolescents
  20. Serum paraoxonase activity and oxidative stress and their relationship with obesity-related metabolic syndrome and non-alcoholic fatty liver disease in obese children and adolescents
  21. Clinical features at diagnosis and responses to antithyroid drugs in younger children with Graves’ disease compared with adolescent patients
  22. Influence of hormonal parameters, bone mineral density and bone turnover on fracture risk in healthy male adolescents: a case control study
  23. Evaluation of lipid and glucose metabolism and cortisol and thyroid hormone levels in obese appropriate for gestational age (AGA) born and non-obese small for gestational age (SGA) born prepubertal Slovak children
  24. Chitotriosidase as a possible marker of clinically evidenced atherosclerosis in dyslipidemic children
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  26. Gut hormone profiles in preterm and term infants during the first 2 months of life
  27. Outcome analysis of aromatase inhibitor therapy to increase adult height in males with predicted short adult stature and/or rapid pubertal progress: a retrospective chart review
  28. A deletion including exon 2 of the TSHR gene is associated with thyroid dysgenesis and severe congenital hypothyroidism
  29. Steroid responsive encephalopathy associated with autoimmune thyroiditis (SREAT) in childhood
  30. Patient Reports
  31. Neonatal diabetes in an infant of diabetic mother: same novel INS missense mutation in the mother and her offspring
  32. Atypical neurologic presentations of new onset type 1 diabetes mellitus in pediatric age group: a report of five unusual cases and review of the literature
  33. Importance of dietary calcium and vitamin D in the treatment of hypercalcaemia in Williams-Beuren syndrome
  34. Vitamin D intoxication in two brothers: be careful with dietary supplements
  35. Transient diabetes insipidus in a preterm neonate and the challenge of desmopressin dosing
  36. A rare case of hypoglycaemia due to insulinoma in an adolescent with acutely altered mental status
  37. Holoprosencephaly: ZIC2 mutation in a case with panhypopituitarism
  38. An association of hypochondroplasia and immune deficiency
  39. Hypophosphatemic rickets caused by a novel PHEX gene mutation in an Indian girl
  40. Psoriasis vulgaris and autoimmune polyendocrine syndrome type I: a case report
  41. Identification of a combined missense/splice-site mutation in FAH causing tyrosinemia type 1
  42. Letter to the Editor
  43. Vitamin D intake and premature infants with intraventricular hemorrhage: how advisable is it?
https://doi.org/10.1515/jpem-2013-0288
Keywords for this article
adolescence; Graves’ disease; growth; outcome; younger children

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Welcome to Assistant Editors at JPEM
  4. Review article
  5. Common approach to childhood obesity in Japan
  6. Images in pediatric endocrinology
  7. Aromatase deficiency in an adolescent girl misdiagnosed as congenital adrenal hyperplasia in infancy and childhood
  8. Original articles
  9. Prevalence of vitamin D deficiency among Iranian adolescents
  10. Analysis of body composition among children and adolescents – a cross-sectional study of the Polish population and comparison of body fat measurement methods
  11. Association of rs8066560 variant in the sterol regulatory element-binding protein 1 (SREBP-1) and miR-33b genes with hyperglycemia and insulin resistance
  12. Differences in anxiety and depression between male and female caregivers of children with a disorder of sex development
  13. Fasting and postprandial levels of a novel anorexigenic peptide nesfatin in childhood obesity
  14. The effect of growth hormone treatment on height in children with idiopathic short stature
  15. Clinical characteristics of type 1 diabetes over a 40 year period in Turkey: secular trend towards earlier age of onset
  16. Relationships of gamma-glutamyltransferase and beta 2-microglobulin on high sensitivity C-reactive protein among Japanese elementary school children
  17. Evaluation of insulin resistance and metabolic syndrome in a group of obese Czech children
  18. Circulating intact parathyroid hormone is suppressed at 25-hydroxyvitamin D concentrations >25 nmol/L in children
  19. Association between vitamin D level and cardiovascular risk in obese children and adolescents
  20. Serum paraoxonase activity and oxidative stress and their relationship with obesity-related metabolic syndrome and non-alcoholic fatty liver disease in obese children and adolescents
  21. Clinical features at diagnosis and responses to antithyroid drugs in younger children with Graves’ disease compared with adolescent patients
  22. Influence of hormonal parameters, bone mineral density and bone turnover on fracture risk in healthy male adolescents: a case control study
  23. Evaluation of lipid and glucose metabolism and cortisol and thyroid hormone levels in obese appropriate for gestational age (AGA) born and non-obese small for gestational age (SGA) born prepubertal Slovak children
  24. Chitotriosidase as a possible marker of clinically evidenced atherosclerosis in dyslipidemic children
  25. Exhaled carbon monoxide in adolescents with diabetic cardiovascular autonomic neuropathy
  26. Gut hormone profiles in preterm and term infants during the first 2 months of life
  27. Outcome analysis of aromatase inhibitor therapy to increase adult height in males with predicted short adult stature and/or rapid pubertal progress: a retrospective chart review
  28. A deletion including exon 2 of the TSHR gene is associated with thyroid dysgenesis and severe congenital hypothyroidism
  29. Steroid responsive encephalopathy associated with autoimmune thyroiditis (SREAT) in childhood
  30. Patient Reports
  31. Neonatal diabetes in an infant of diabetic mother: same novel INS missense mutation in the mother and her offspring
  32. Atypical neurologic presentations of new onset type 1 diabetes mellitus in pediatric age group: a report of five unusual cases and review of the literature
  33. Importance of dietary calcium and vitamin D in the treatment of hypercalcaemia in Williams-Beuren syndrome
  34. Vitamin D intoxication in two brothers: be careful with dietary supplements
  35. Transient diabetes insipidus in a preterm neonate and the challenge of desmopressin dosing
  36. A rare case of hypoglycaemia due to insulinoma in an adolescent with acutely altered mental status
  37. Holoprosencephaly: ZIC2 mutation in a case with panhypopituitarism
  38. An association of hypochondroplasia and immune deficiency
  39. Hypophosphatemic rickets caused by a novel PHEX gene mutation in an Indian girl
  40. Psoriasis vulgaris and autoimmune polyendocrine syndrome type I: a case report
  41. Identification of a combined missense/splice-site mutation in FAH causing tyrosinemia type 1
  42. Letter to the Editor
  43. Vitamin D intake and premature infants with intraventricular hemorrhage: how advisable is it?
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