I-131 THERAPY OF HYPERTHYROIDISM IN PEDIATRIC-PATIENTS

The purpose of this retrospective study was to evaluate the utility of I-131 as therapy for hyperthyroidism in children and to evaluate its short-term side effects. Methods: The results of I-131 therapy of hype rthyroidism were evaluated in a group of 35 pediatric patients. Result s: In 29 patients propylthiouracil or methimazole therapy was abandone d due to noncompliance (13), relapse or failure to control hyperthyroi dism (13), vasculitis (1), neutropenia (1) or a lupus-like syndrome (1 ). Average treatment activity was 7.7 +/- 2.9 (s.d.) mCi, correspondin g to 0.16 +/- 0.03 mCi/g. Thirty patients (86%) received a single radi oiodine treatment and five (14%) were retreated. In patients who becam e hypothyroid after a single dose, hypothyroidism was noted within 100 days of treatment. Clinical management problems included vomiting in four patients and enuresis in four patients. Mild radiation thyroiditi s occurred in one patient and nodularity was noted after therapy in tw o patients. Conclusion: Iodine-131 is effective for both initial treat ment of hyperthyroidism and the treatment of medical treatment failure s in pediatric patients. Awareness of vomiting and enuresis as potenti al management problems is crucial when using I-131 in this age group. Therefore, special treatment precautions may be required.