Introduction: In this presentation, data on 67 hyperthyroid patients , aged 5 to 18 years, (53 female) who presented to an endocrine referral centre in Calcutta, India, between 1996 and 2010 are analysed.
Material & Methods: All patients had a full clinical examination. Free T3, Free T4 and TSH were measured by a chemiluminescence assay and thyroiditis was excluded. Only 21 patients (32 %) were 12 years or younger. Estimated goitre size was 20 g or more in 11 patients (16 %). Four patients had multinodular goitres and 1 had a toxic nodule. Surgery was advised for the largest MNG (n=1) and I 131 for the toxic nodule. The others were given a choice of treatments and were made aware of the poor remission rate on medical treatment. All patients chose carbimazole treatment as their first choice of treatment and agreed to consider radioiodine if there was a relapse after 2 years.
Results: Thirty three patients (49%) remained on regular follow up. Ten of the dropouts were contacted at random. All said that they could not accept alternatives to medical treatment. Seven patients went into remission; 3 relapsed and 4 (12%) are in remission for 1830 months. All patients continuing carbimazole for 18 months or more were counseled on each visit to stop the treatment and have radioiodine ablation. One patient who relapsed, accepted this advice. The rest felt that they should continue carbimazole indefinitely.
Conclusion: The safety of radioiodine treatment for hyperthyroidism in children has been well documented as has the poor remission rate on medical treatment. This study shows that patients are extremely reluctant to accept radioiodine as a treatment modality.
Declaration of interest: There is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.
Funding: No specific grant from any funding agency in the public, commercial or not-for-profit sector.