GRAVES' DISEASE

CLINICAL FEATURES AND SHORT-TERM OUTCOMES

Abstract

INTRODUCTION
Graves’ disease is an uncommon disease in childhood with prevalence of 0.02%. It accounts for most of the thyrotoxicosis in paediatric population. Treatment option is limited and the reported remission rate is low.

METHODOLOGY
This is a descriptive study. All patients with Graves’ disease who attended the endocrine clinic in Sabah Women and Children’s Hospital are enrolled. Data was obtained through review of their medical records. Their clinical features and treatment outcome were described. Results are expressed as numerical values (percentages) for categorical variables and medians (25th, 75th percentiles) for continuous variables.

RESULTS
A total of nine patients were studied whereby 78% of them are female. Their median age of presentation is 9.0 years old (3.5, 11.6). Most common presenting features are goitre, exophthalmos and tachycardia. At presentation, their median FT4 is 51 pmol/L (29, 75). Most patient had a positive thyroid receptor antibody. All patients were treated with carbimazole, median dose of 0.6 mg/kg/d (0.5, 1.0). One patient had additional thyroxine to the treatment (block and replace) due to wide fluctuation in thyroid function. None of the patients experienced side effects from treatment. Median duration of follow up is 3.4 year (1.1, 8.2). Only one patient (11%) in this cohort achieved remission.

CONCLUSION
Our study shows that achieving remission is challenging in paediatric Graves’ disease. Carbimazole is a safe treatment option within the duration of follow up in our cohort.