Trends in Management and Outcomes of Pediatric Hyperthyroidism Over Two Decades
Authors' conclusion
Over the past two decades, the management of pediatric HT has evolved toward more prolonged medical therapy and decreased reliance on definitive treatments. This change in practice appears to coincide with an increased relapse rate, underscoring the clinical implications of these changes.
Study context
- Population
- Children aged 2–18 years diagnosed with hyperthyroidism (HT) between 2000 and 2019, receiving antithyroid drugs (ATDs) ≥6 months, followed up through 2024; 75% females, median age at diagnosis 15.1 (13.0–16.5) yearsof 5,111,304 insured children
- Participants
- 518 children
- Exposure
- Diagnosis in 2010-2019 vs 2000-2009
- Outcome
- Definitive treatment, nonremission and relapse by diagnosis period
- Follow-up
- Median 10.4 (6.5-15.1) years
Methodological detailshealth maintenance organization database
- Health maintenance organization database
Main finding
As reported in the abstract
Definitive treatment
27.5% vs. 59.6%
P < 0.001
2010-2019
Nonremission
19.0% vs. 3.8%
P < 0.001
2010-2019
Relapse
15.9% vs. 4.6%
P < 0.001
2010-2019
Observational data: associations, not effects.
Further findings
Initial methimazole dose
P = 0.030
| Outcome | P value |
|---|---|
| Baseline FT4 at diagnosis, late vs early remission | P = 0.014 |
- Baseline FT4 at diagnosis, late vs early remission: Late remission 42.4 (range 26.7–61.5) pmol/L
- Baseline FT4 at diagnosis, late vs early remission: Early remission 32.6 (range 24.4–42.5) pmol/L
ATD treatment duration and remission
- Median ATD treatment duration
- 3.8 (1.8-6.6) years
- Overall remission rate
- 31.1%
- Children achieving remission
- 161
- Median time to remission
- 2.36 years
Predictors of later remission
- Younger age associated with later remission
- P = 0.010
- Antithyroid peroxidase positivity associated with later remission
- P = 0.018
Original publication
Trends in Management and Outcomes of Pediatric Hyperthyroidism Over Two Decades. Thyroid. Published 25 June 2026. doi:10.
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