Grave's disease (GD) is an
autoimmune disease in which excessive amounts of
thyroid hormones circulate in the blood. Treatment for pediatric GD includes (1)
antithyroid drugs (ATD), (2) radioiodine, and (3)
thyroidectomy. Yet, the optimal
therapy remains controversial. We collected studies from all electronically available sources as well as from conferences held in China. All studies using radioiodine and/or ATD and/or
thyroidectomy were included. Information was found on 1,874 pediatric GD patients treated with radioiodine, 1,279 patients treated with ATD and 1,362 patients treated surgically. The cure rate for radioiodine was 49.8%; the incidence of
hypothyroidism, 37.8%; of relapse, 6.3%; of adverse effects, 1.55%; and of drop outs, 0.6%. These data show that radioiodine treatment is safe and effective in pediatric GD with significant lower incidence of relapse and adverse effects but significantly higher incidence of
hypothyroidism as compared with both ATD and
thyroidectomy. For the time being, radioiodine treatment for pediatric GD remains an excellent first-line
therapy and a good second-line
therapy for patients with ATD failure, severe complications, or poor compliance.