%0 Journal Article
%T Prediction of post-treatment hypothyroidism using changes in thyroid volume after radioactive iodine therapy in adolescent patients with Graves' disease
%A Nobuhiro Nakatake
%A Shuji Fukata
%A Junichi Tajiri
%J International Journal of Pediatric Endocrinology
%D 2011
%I BioMed Central
%R 10.1186/1687-9856-2011-14
%X The aim of this retrospective study was to examine whether changes in thyroid volume predict post-treatment hypothyroidism in adolescent Graves' disease patients.We used ultrasonography to examine changes in thyroid volume, and also assessed thyroid functions, at 0, 1, 3, 5, 8 and 12 months after iodine-131 treatment in 49 adolescents ranging in age from 12 to 19 years retrospectively. Based on thyroid function outcome at 12 months, patients were divided into two groups: 29 patients with overt hypothyroidism requiring levothyroxine replacement and 20 without overt hypothyroidism. We compared changes in post-radioiodine thyroid volume between the two groups.About 90% of patients whose thyroid volume at 3 months after iodine-131 administration was less than 50% of the original volume were hypothyroid by one year after treatment (positive predictive value 88%, sensitivity 75.9%, specificity 85.0%).We believe ultrasonographic measurement of thyroid volume at 3 months after iodine-131 to be clinically useful for predicting post-treatment hypothyroidism in adolescent Graves' disease patients.Graves' disease (GD) is the most common cause of hyperthyroidism in children, adolescents and adults [1-3]. Treatments available for GD include anti-thyroid medications (methimazole or propylthiouracil), surgery and radioactive iodine (RAI) [4,5]. There is ongoing debate worldwide regarding the most suitable therapy for GD in pediatric patients. Although anti-thyroid medications are commonly used as first-line therapy for pediatric GD, long-term remission occurs in only 20% to 30% of pubertal cases and 15% of pre-pubertal cases treated pharmacologically [3,6-8]. Consequently, either surgery or RAI is needed to achieve a long-term cure in most pediatric GD patients.RAI therapy is generally considered to be safe, inexpensive and effective, with relatively few side effects [8-10]. Radioiodine was introduced for the treatment of GD more than 50 years ago [11], and at present is the most c
%U http://www.ijpeonline.com/content/2011/1/14