{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T04:15:49Z","timestamp":1791605749184,"version":"4.3.4"},"reference-count":103,"publisher":"Bioscientifica","issue":"1","license":[{"start":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T00:00:00Z","timestamp":1643673600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["etj.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,2,1]]},"abstract":"<jats:p>Hyperthyroidism caused by Graves\u2019 disease (GD) is a relatively rare disease in children. Treatment options are the same as in adults \u2013 antithyroid drugs (ATD), radioactive iodine (RAI) or thyroid surgery, but the risks and benefits of each modality are different. The European Thyroid Association guideline provides new recommendations for the management of pediatric GD with and without orbitopathy. Clinicians should be alert that GD may present with behavioral changes or declining academic performance in children. Measurement of serum TSH receptor antibodies is recommended for all pediatric patients with hyperthyroidism. Management recommendations include the first-line use of a prolonged course of methimazole\/carbimazole ATD treatment (3 years or more), a preference for dose titration instead of block and replace ATD, and to avoid propylthiouracil use. Where definitive treatment is required either total thyroidectomy or RAI is recommended, aiming for complete thyroid ablation with a personalized RAI activity. We recommend avoiding RAI in children under 10 years of age but favor surgery in patients with large goiter. Pediatric endocrinologists should be involved in all cases.<\/jats:p>","DOI":"10.1530\/etj-21-0073","type":"journal-article","created":{"date-parts":[[2022,1,4]],"date-time":"2022-01-04T05:09:33Z","timestamp":1641272973000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-16","source":"Crossref","is-referenced-by-count":116,"title":["2022 European Thyroid Association Guideline for the management of pediatric Graves\u2019 disease"],"prefix":"10.1530","volume":"11","author":[{"given":"Christiaan F","family":"Mooij","sequence":"first","affiliation":[{"name":"Department of Pediatric Endocrinology, Emma Children\u2019s Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy D","family":"Cheetham","sequence":"additional","affiliation":[{"name":"Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, UK"},{"name":"Department of Pediatric Endocrinology, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederik A","family":"Verburg","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Eckstein","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Duisburg Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon H","family":"Pearce","sequence":"additional","affiliation":[{"name":"Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, UK"},{"name":"Endocrine Unit, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliane","family":"L\u00e9ger","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology and Diabetes, Reference Center for Rare Endocrine Growth and Development Diseases, Endo-ERN HCP, Assistance Publique-H\u00f4pitaux de Paris, Robert Debr\u00e9 University Hospital, University of Paris, NeuroDiderot Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A S Paul","family":"van Trotsenburg","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Emma Children\u2019s Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"666","article-title":"A case for clarity, consistency, and helpfulness: state-of-the-art clinical practice guidelines in endocrinology using the grading of recommendations, assessment, development, and evaluation system","volume":"93","author":"Swiglo","year":"2008","unstructured":"Swiglo BAMurad MHSchunemann HJKunz RVigersky RAGuyatt GHMontori VM. 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