Influence of prior carbimazole on the outcome of radioiodine therapy in pediatric and adolescent Graves' disease. Issue 6 (June 2015)

• Record Type: Journal Article
• Authors: Ballal, Sanjana; Soundararajan, Ramya; Singh, Harmandeep; Garg, Aayushi; Chopra, Saurav; Bal, Chandrasekhar
• Is Part Of: Nuclear medicine communications. Volume 36:Issue 6(2015:Jun.)
• Publication Date: 2015-06
• Subjects: antithyroid drug therapy -- pediatric Graves' disease -- radioiodine therapy; Nuclear medicine -- Periodicals; 616.07575
• DOI: 10.1097/MNM.0000000000000291
• Languages: English
• ISSNs: 0143-3636

Abstract

Abstract : Objective of the study: Therapeutic options for pediatric Graves' disease (PGD) include antithyroid drug therapy (ATD) as the first line and radioiodine (I-131) therapy as the second line of treatment. To date, controversies persist regarding the true effect of prior ATD in the outcome of I-131 therapy in PGD. This study evaluated the effect of prior carbimazole treatment on the outcome of I-131 therapy in PGD. Methods: This is a retrospective study covering the years 1995–2012, with a median follow-up of 75 months. Records of 114 children (84 girls and 30 boys, age range: 5–20 years, mean 24-h radioiodine uptake, 58%) who had clinically and biochemically proven Graves' disease irrespective of prior ATD therapy were included. All patients were treated with fixed doses of 5 mCi (185 MBq) I-131 for Graves' disease; 74 had undergone prior carbimazole treatment (group 1) and 40 were drug naive (group 2). The endpoint of follow-up was stable euthyroid or hypothyroid in patients. The effect of prior carbimazole treatment on the outcome of I-131 therapy in PGD patients was evaluated. The success of radioiodine therapy was defined as the cure of hyperthyroidism. Variables were analyzed to identify the potential predictive factors for euthyroidism/hypothyroidism after treatment. Results: The cure rate was 70% in group 1 and 83% in group 2 with a single dose of radioiodine ( P =0.299). The success rate achieved at the end of 1-year follow-up in group 1 and group 2 was 81 and 87%, respectively ( P =0.401). No independent predictor was associated with success or failure of treatment. At the median follow-up of 75 months (range: 12–216 months), 76% of patients were hypothyroid on replacement doses of levothyroxine and 24% still continued to be euthyroid. Conclusion: Prior carbimazole treatment does not alter the outcome of radioiodine therapy in PGD.