Graves' Disease in Children: An Update.

IF 2.7 Q3 ENDOCRINOLOGY & METABOLISM Clinical Medicine Insights-Endocrinology and Diabetes Pub Date : 2023-05-03 eCollection Date: 2023-01-01 DOI:10.1177/11795514221150615

Kotb Abbass Metwalley, Hekma Saad Farghaly

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Abstract

Graves' disease (GD) is the most common cause of hyperthyroidism in children. A common GD symptom is a goiter. The usual biochemical profile in children with GD is a decreased thyroid hormone stimulating hormone (TSH) level and high free thyroxine (FT4) and free triiodothyronine (FT3) concentrations. The presence of thyroid receptor antibodies (TRAb) is the most important specific immunological sign for diagnosing GD. The treatment choices for pediatric GD are anti-thyroid drugs (ATDs), radioiodine, and thyroidectomy, but the risks and benefits of each modality are different. Management recommendations include the first-line use of a prolonged course of ATDs for at least 3 years and potentially 5 years or more. Rituximab and Teprotumumab are new novel alternative medications for the treatment of adult patients with GD and Graves' orbitopathy respectively, but evidence of the efficacy and safety of these drugs in pediatric patients with GD is lacking.

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儿童巴塞杜氏病：最新进展。

巴塞杜氏病（GD）是儿童甲状腺功能亢进症最常见的病因。常见的GD症状是甲状腺肿大。GD患儿通常的生化指标是促甲状腺激素（TSH）水平降低，游离甲状腺素（FT4）和游离三碘甲状腺原氨酸（FT3）浓度升高。甲状腺受体抗体（TRAb）的存在是诊断 GD 最重要的特异性免疫学标志。小儿 GD 的治疗方法有抗甲状腺药物（ATD）、放射性碘和甲状腺切除术，但每种方法的风险和益处各不相同。治疗建议包括一线使用长疗程的抗甲状腺药物，疗程至少3年，也可能5年或更长。利妥昔单抗（Rituximab）和特普鲁单抗（Teprotumumab）是分别用于治疗成人GD患者和巴塞杜氏眶病患者的新型替代药物，但这些药物在儿童GD患者中的疗效和安全性尚缺乏证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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