Definitive treatment of Graves' disease in children and adolescents.

Graves' disease (GD) is the most common cause of pediatric hyperthyroidism. In children and adolescents the clinical GD course is different from this seen in adults, due to low remission rate and high prevalence of adverse events related to treatment with antithyroid drugs (ATDs). The majority of patients in this group require definitive therapy. As in adults, there are two treatment options - thyroid ablation with radioactive iodine (RAI) or surgery with preferred procedure of total thyroidectomy (TT). The choice of definitive therapy depends on many important factors such as children's age, effectiveness of the first- line ATD treatment, presence of ATDs side effects, presence of large goiter or thyroid nodules and concomitant diseases. The following paper provides the current guidelines on GD management in children and compares the efficacy of both definitive treatment methods as well as the acute and long-term complication rates, which must be taken into account to choose the optimal therapeutic option.