Key discussion points
Make sure you know what it is that you are treating is this Graves hyperthyroidism (with associated TSH receptor antibodies) or simply a brief, hyperthyroid phase of autoimmune thyroid disease (without TSH receptor antibodies) that will settle down spontaneously?
Ideally obtain the result of the thyroid receptor antibody titre pre intervention with carbimazole.
Unrecognised Graves can have a profound impact on educational attainment. Time with unrecognised Graves can compromise an individuals ability to learn to a major degree.
All treatment modalities carbimazole, radioiodine (RI) and surgery have their advantages and disadvantages. Tailoring therapy to the individual according to factors such as age, goitre size and future plans is important.
Block and replace antithyroid drug therapy may be appropriate in some instances despite the increased likelihood of adverse events.
Some patients with Graves will not only remit but will also become hypothyroid.
Life on long-term thyroid hormone replacement post-surgery or post-RI is not perfect we need new treatments for Graves hyperthyroidism that increase the likelihood of long-term remission.
22 - 24 Nov 2017
British Society for Paediatric Endocrinology and Diabetes