Endocrine Abstracts

Background: Treatment options for Graves’ disease (GD) and multinodular goitre include antithyroid medication, near total thyroidectomy and radioactive iodine (RAI). RAI is an established treatment for GD in the adult population but is used less commonly in children and the adolescent population due to concerns with regards to safety.

Methods: A review of a series of 14 adolescent patients receiving RAI between 2007 and 2013 in our department was performed retrospectively. This was done via review of case notes, GP follow up details and direct patient interview.

Results: The group consisted of four male and ten female patients between the ages of 11 and 19 years. RAI dose received ranged from 419 to 803 MBq. Four of the patients underwent RAI due to large multinodular goitres. A further five of the 14 patients received RAI as they remained thyrotoxic clinically and biochemically despite oral antithyroid therapy. Additionally, three of the 14 patients had poor compliance whilst the remaining two relapsed following treatment with oral antithyroid therapy. All patients underwent a clinically significant reduction in goitre size after RAI with an improvement in quality of life soon after treatment. There was a marked improvement in thyroid function particularly in the thyrotoxic patients. Seven of the 14 patients developed hypothyroidism between 4 and 12 weeks after RAI whilst a second RAI dose was required in one patient. There was no report of malignancy in this group of patients.

Conclusion: RAI is an effective and well tolerated treatment in this age group resulting in a marked reduction in goitre size and improvements in quality of life.