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. 2023 Oct 23;23(1):233.
doi: 10.1186/s12902-023-01484-2.

Different doses of methimazole treatment of children and adolescents with graves' disease: a clinical study based on 161 cases of outpatients

Peng Li #  1 , Wei Wang #  2 , Meiqin Yan  1 , Xianhui Zhang  1 , Jie Pan  3 , Lina Gong  4
Affiliations

Different doses of methimazole treatment of children and adolescents with graves' disease: a clinical study based on 161 cases of outpatients

Peng Li et al. BMC Endocr Disord. .

Abstract

Objective: This study aimed to evaluate the association between the initial dose of MMI and the clinical course, as well as adverse effects on young people with GD.

Methods: One hundred and sixty-one children and adolescents with newly diagnosed GD were enrolled for this study and categorized into four groups based on initial serum-free T3 and T4 levels and daily MMI doses: Group A (mild, 0.3-0.5 mg/kg/day, n = 78), Group B (moderate, 0.6-0.8 mg/kg/day, n = 37), Group C (severe, 0.6-0.8 mg/kg/day, n = 24), and Group D (severe, 0.8-1.0 mg/kg/day, n = 22). The thyroid function, blood cell analysis and liver function were examined before treatment and at 4, 8 and 12 weeks after treatment. Outcome of long-term follow-up were also observed.

Results: After 12 weeks of treatment, 91.0% of the patients in group A and 90.9% of the patients in group D recovered to normalization of FT3, which was slightly higher than the other two groups; 70.8% of the patients in group C recovered to normalization of FT4, which was slightly lower than that in the other three groups. The incidence of minor adverse effects was 12.8% in group A, 13.5% in group B, 16.7% in group C and 40.9% in group D (P < 0.01). Remission was achieved in 38 patients (23.6%).

Conclusions: Lower doses of MMI (0.3-0.5 mg/kg/day) are suitable for mild GD, and higher doses of MMI (0.6-0.8 mg/kg/day) are advisable for moderate or severe GD. Much higher doses of MMI (0.8-1.0 mg/kg/day) are harmful for initial use in children and adolescents with GD patients.

Keywords: Adolescents; Adverse effects; Children; Graves’ Disease; Methimazole.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Distribution of 161 children and adolescents with GD according to age and sex at diagnosis
See this image and copyright information in PMC

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