Radioiodine therapy of thyrotoxicosis in children and adolescents. Indications, efficacy and safety. Literature review

Graves’ disease (GD) is the most prevalent cause of thyrotoxicosis in children. Comprehensive clinical practice contains three methods of choice in the treatment of GD: antithyroid drugs, radioactive iodine and surgery. All these treatment methods are using for a long time resulting in great amount clinical experience accumulated. Virtually in all cases the treatment starting with antithyroid drugs and then inefficiency or complications leads to choose the alternative treatment method. The conscious choice of treatment method is based on potential efficacy and safety parameters understanding as well as affecting factors. The purpose of this review – a critical evidence-based analysis of efficacy/safety of radioiodine treatment of GD in children and adolescents compared with other treatment methods as well as the place and indications for this type of treatment in contemporary clinical practice of endocrinologists, radiologists and endocrine surgeons. The choice of treatment strategy at any step is adjusting with patient and his parents/guardians by informing with objective merits and demerits of methods upon existing evidence basis. Main recommendations of effective and safe therapy of GD with radioiodine in children and adolescents are also disclosed.