Abstract:
OBJECTIVE:To compare the presentation and clinical course of Graves' disease (GD) in two pediatric populations consisting of 28 patients with Down's syndrome (DS) and 109 controls without DS respectively. DESIGN AND METHODS:The evolution over time of GD was determined in both groups according to the clinical changes and the variations in TSH, free thyroxine, and TSH receptor autoantibodies serum levels during the entire follow-up. RESULTS:Female prevalence (50 vs 81.6%; chi(2)=12.0, P<0.0005) and average age at GD presentation (9.9+/-4.4 vs 11.5+/-3.5 years, P<0.05) were significantly lower in DS group than in controls. Clinical responsiveness to methimazole therapy was significantly better in DS patients, as demonstrated by both the lower relapse rates after the first cycle withdrawal (7.1 vs 31.2%; chi(2)=7.4, P<0.005) and the higher persistent remission rates after definitive therapy withdrawal (46.4 vs 26.7%; chi(2)=4.1, P<0.05). Moreover, in DS group, no patients needed surgery or radioiodine ablation, whereas non-pharmacological treatment was necessary in 11% of controls (chi(2)=3.8, P<0.05). Antecedents of Hashimoto's thyroiditis (HT) were documented in 21.4% of DS patients and in 3.7% of controls (chi(2)=10.4, P<0.005). Association with other autoimmune diseases was detected in 32.1% of DS cases and in 12.8% of controls (chi(2)=5.94, P<0.025). CONCLUSIONS:GD in DS children and adolescents is characterized by several peculiarities: i) earlier presentation; ii) no gender predominance; iii) less severe clinical course; iv) higher frequency of documented HT antecedents; v) more frequent association with other autoimmune diseases.
journal_name
Eur J Endocrinoljournal_title
European journal of endocrinologyauthors
De Luca F,Corrias A,Salerno M,Wasniewska M,Gastaldi R,Cassio A,Mussa A,Aversa T,Radetti G,Arrigo Tdoi
10.1530/EJE-09-0751subject
Has Abstractpub_date
2010-03-01 00:00:00pages
591-5issue
3eissn
0804-4643issn
1479-683Xpii
EJE-09-0751journal_volume
162pub_type
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journal_title:European journal of endocrinology
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journal_title:European journal of endocrinology
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doi:10.1530/eje.0.1450497
更新日期:2001-10-01 00:00:00
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journal_title:European journal of endocrinology
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journal_title:European journal of endocrinology
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更新日期:2000-02-01 00:00:00
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更新日期:2002-07-01 00:00:00
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journal_title:European journal of endocrinology
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doi:10.1530/eje.0.1440139
更新日期:2001-02-01 00:00:00
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更新日期:2012-06-01 00:00:00
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更新日期:2008-04-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1996-10-01 00:00:00
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pub_type: 杂志文章
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更新日期:2008-12-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1340386
更新日期:1996-03-01 00:00:00
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更新日期:2008-12-01 00:00:00
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更新日期:2000-04-01 00:00:00
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更新日期:1999-12-01 00:00:00
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journal_title:European journal of endocrinology
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更新日期:2011-10-01 00:00:00
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更新日期:2001-04-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-07-0137
更新日期:2007-09-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1350666
更新日期:1996-12-01 00:00:00
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pub_type: 杂志文章
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更新日期:2016-10-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-16-0945
更新日期:2017-04-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-17-0468
更新日期:2017-11-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1420651
更新日期:2000-06-01 00:00:00
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pub_type: 杂志文章
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更新日期:2009-05-01 00:00:00