Approaches for improving diagnostics precision, treatment anh monitoring relapse of graves

Phuong Thao Bui; Chi Dung Vu; Thuy Trang Ngo; Ngoc Khanh Nguyen; Thi Bich Ngoc Can; Hoang Lan Nguyen

doi:10.1530/endoabs.110.EP1525

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Endocrine Abstracts (2025) 110 EP1525 | DOI: 10.1530/endoabs.110.EP1525

ECEESPE2025 ePoster Presentations Thyroid (198 abstracts)

Approaches for improving diagnostics precision, treatment anh monitoring relapse of graves’ disease in national children’s hospital

Thao Bui Phuong ¹ , Dung Vu Chi ¹ , Trang Ngo Thuy ¹ , Khanh Nguyen Ngoc ¹ , Ngoc Can Thi Bich ¹ & Lan Nguyen Hoang ¹

Author affiliations

¹Vietnam National Children’s Hospital, Center for Endocrinology, Metabolism, Genetics, and Molecular Therapy, Hanoi, Viet Nam

JOINT2755

Research objective: Clarifying the relationship between TrAb antibody concentration and some clinical and paraclinical characteristics in pediatric Graves’ disease and applying TrAb antibody testing in monitoring relapse of Graves’ disease in children, requiring to use attacking dose of antithyroid drugs during maintenance phase. Research subjects: 58 patients (from 24 months old to under 18 years old) treated at The Center of Endocrinology, Metabolism, Genetics and Molecular Therapy, Vietnam National Children’s Hospital from Jan 2021 to Oct 2024. Research method: Case series study.

Results: The mean age of patients in the study was 9.6±3.1 years. The ratio of female/male patients was 2.4/1. The mean time for patients to see doctors since progression was 2.2±1.8 months: this figures were 2.3±1.1 months in boys and 2.2±2.2 months in girls. The main reason for going to hospitals was thyrotoxicosis (71.2%). Common physical symptoms were hot and moist skin, hand tremors, tachycardia, bulging eyes and goiter, overeating. The other symptoms were weight loss (58.6%), insomnia (55.2%), and nervousness (46.6%). In our 58 patients, 9 patients(15.5%) developed relapse. The mean time to have relapse since starting treatment was 15.8±4.8 months. The mean TrAb concentrations of patients at the time of diagnosis, the end of attacking dose time, and maintenance phase were 22.4±11.3 U/l, 15.6±11.4 U/l and 8.8±8.1 U/l, respectively. The patients’ mean TrAb concentrations at the time of diagnosis, the end of attacking dose time, and maintenance phase were higher in relapse patients, compared to that of non-relapse patients, but the difference was not significant.

Conclusion: The disease has a long-term course of relapse, recurrence, requiring early treatment to avoid ophthalmological, cardiovascular, and neurological complications that affect children’s physical development as well as their ability to work and study. Quantifying TrAb levels at diagnosis and during treatment helps to confirm the diagnosis of Graves’ disease, but may not predict relapse.

Keywords: Graves’ disease, hyperthyroidism, TrAb, children.