How do paediatricians use and monitor antithyroid drugs in the UK? A clinician survey.
carbimazole
graves disease
hyperthyroidism
immunosuppression
thionamide
Journal
Clinical endocrinology
ISSN: 1365-2265
Titre abrégé: Clin Endocrinol (Oxf)
Pays: England
ID NLM: 0346653
Informations de publication
Date de publication:
09 2019
09 2019
Historique:
received:
06
04
2019
revised:
17
05
2019
accepted:
06
06
2019
pubmed:
11
6
2019
medline:
10
9
2020
entrez:
11
6
2019
Statut:
ppublish
Résumé
We aimed to document current practice in the medical management of paediatric hyperthyroidism in the UK and compare to international recommendations. A 27-question online survey distributed via an electronic newsletter in August 2018. Responses from 48 members (11%) of the British Society for Paediatric Endocrinology and Diabetes. Information about antithyroid drug (ATD) preference, treatment duration, monitoring of full blood count (FBC), management of neutropaenia, agranulocytosis screening and patient education. Carbimazole is favoured by 98% of respondents and a "dose titration" regimen preferred over "block and replace" (65% vs 29%). TRAbs (thyroid-stimulating hormone receptor antibodies) are used for diagnostic purposes by 85% and by 33% to look for evidence of disease remission. The majority (81%) treat for a minimum of 2 years before considering a trial off ATD. All respondents reported that they "always/usually" warn their patients about the risk of agranulocytosis before starting ATD, but written information is "rarely/never" provided by 63%. Sore throat (98%) and fever (92%) are the most commonly cited symptoms used to alert a patient to possible agranulocytosis. FBC is measured prior to treatment by 65% and measured periodically during treatment by 70%. The management of paediatric hyperthyroidism with ATDs in the UK is not consistent with all international recommendations because a block and replace ATD regimen remains widely used. TRAbs are utilized at presentation, but underused for detecting disease remission. National consensus guidelines and written patient information may refine the management of paediatric patients on ATDs.
Substances chimiques
Antithyroid Agents
0
Banques de données
figshare
['10.6084/m9.figshare.7962839.v1', '10.6084/m9.figshare.7962860.v1']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
417-423Informations de copyright
© 2019 John Wiley & Sons Ltd.
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