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

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.