ESPE2024 Poster Category 2 Thyroid (25 abstracts)
Graves disease in children and adolescents, results of a multicenter Algerian study
Meryem Bensalah 1 , Kamelia Boulesnanae 2 , Fadila Bouferoua 3 , Mimouna Bessahraoui 4 , Adel Djermane 5 , Sakina Kherra 6 , Nihad Selim 7 , Hakima Abes 8 , Malek Iabbassen 9 , Fatma Berkoune 10 , Akli Taazibt 10 , Mounira Chanegriha 10 , Asmahane Laadjouz 2 & Yasmine Ouarezki 5
1Endocrinology Unit, Central Hospital of the Army, Algiers, Algeria. 2Pediatric Department, Mohamed Debaghine Hospital, Algiers, Algeria. 3Pediatric Department. Issad Hassani Hospital, Algiers, Algeria. 4Pediatric Departement, Canastel Hospital, Oran, Algeria. 5Pediatric Department, Belfort Hospital, Algiers, Algeria. 6Pediatric Department, Nafissa Hamoud Hospital, Algiers, Algeria. 7Pediatric Departement, Clinique Sainte thérèse, Annaba, Algeria. 8Pediatric Departement, Douera Hospital, Algiers, Algeria. 9Endocrinology Unit HMRUB, Bechar, Algeria. 10Mother and Child Hospital of the Army, Algiers, Algeria
Background: Graves’ disease (GD) is a rare autoimmune affection in children with a female predominance. Its prevalence is about 0,1/100 000py in children and 3/100 000 py in adolescents and characterized by more important frequency of relapse than adults after medical treatment.
Aim: Is to evaluate clinical biological radiological and treatment outcome of children and adolescents affected by GD in nine Algerian hospital centers between January 2006 and January 2024.
Results: The study enrolled 92 patients with female predominance (72%). Mean age was 10, 29 years [3-18]. Patients origin was from the center of the country in 57, 7% of the cases. Familial GD was found in 10% of cases, 13% of patients had a history of autoimmune disease and 6, 5 % of them were affected by Down syndrome. Clinically, goiter was present in 91 % of patients, tachycardia in 64 % of patients, Exophthalmos in 57,6 %, sweating in 45,6% and academic difficulties in 38 % of patients. FT4 was elevated in all the patients, one child present FT3 hyperthyroidism, mean FT4 was 49,7 pmol/l and it was more than 50 pmol/l in 34 % of patients. Thyroid stimulating anti body were evaluated in 66 from the 92 patients and were high in all with a meddle rate of 14,48U/l. Ultrasound neck found a goiter according to WHO references in 90 % of patients, two patients had nodules and 24% a high blood flow in the inferior thyroid artery. Concerning patients care, Long term medical treatment (LTMT) by anti thyroid drugs without discontinuation was the most common attitude adopted in 72 patients with a mean duration of 44 months [3 months -10 years] without major side effects. Sixteen patients beneficed for LTMT with discontinuation and relapse in 9 patients who were treated with radioiodine at a meddle age of 16, 9 years after a period of medical treatment of 59 months with a mean dose of 600µCi/G of thyroid tissue. Surgery has been performed in four patients because of the association with papillary thyroid carcinoma in one case, large goiter in two cases and inobservance of medical treatment in one case.
Conclusion: The diagnosis of GD in our cohort was evident. Long term medical treatment was the most common attitude with good observance and tolerance, radioiodine treatment was a good alternative administrated at middle age close to adolescence with an ablative dose.
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