Retrospective Study
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World J Clin Cases. Feb 6, 2022; 10(4): 1190-1197
Published online Feb 6, 2022. doi: 10.12998/wjcc.v10.i4.1190
Clinical effect of methimazole combined with selenium in the treatment of toxic diffuse goiter in children
Xiao-Hong Zhang, Gao-Pin Yuan, Ting-Li Chen
Xiao-Hong Zhang, Gao-Pin Yuan, Ting-Li Chen, Department of Pediatric Endocrinology, Quanzhou Women and Children’s Hospital, Quanzhou 362000, Fujian Province, China
Author contributions: Zhang XH, Yuan GP, and Chen TL designed and performed the study; Zhang XH, Yuan GP, and Chen TL analyzed the data; all authors contributed to the writing and revising of the manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of the Quanzhou Maternal and Child Hospital.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: No conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Hong Zhang, MD, Doctor, Department of Pediatric Endocrinology, Quanzhou Women and Children’s Hospital, No. 700 Fengze Street, Quanzhou 362000, Fujian Province, China. zhangxiaohong2109@163.com
Received: October 22, 2021
Peer-review started: October 22, 2021
First decision: November 17, 2021
Revised: December 1, 2021
Accepted: December 22, 2021
Article in press: December 22, 2021
Published online: February 6, 2022
Processing time: 94 Days and 7.5 Hours
Abstract
BACKGROUND

The incidence of toxic diffuse goiter (Graves’ disease) is higher in adolescents and preschool-aged children, with an upward trend. The incidence at 6–13 years of age is approximately 11.0%, and the incidences in men and women are 7.8% and 14.3%, respectively.

AIM

To explore the clinical effect of methimazole combined with selenium in the treatment of toxic diffuse goiter (Graves’ disease) in children and its effect on serum anti-thyroglobulin antibody (TRAb) and anti-thyroid peroxidase antibody (TPOAb).

METHODS

A total of 103 children with Graves’ disease treated in our hospital from January 2018 to June 2021 were divided into a traditional group and a combined group (15-20 mg methimazole orally given to children) and a combined group (50 µg selenium added on the basis of traditional treatment) according to different treatment methods to explore the therapeutic effects of the two methods and to observe the changes in thyroid volume and serum TRAb, TPOAb, free thyroxine (FT4) and inflammatory factor levels before and after treatment. The time taken for FT4 to return to normal was compared between the two groups.

RESULTS

Treatment was significantly more effective in the combined group than in the traditional group (P < 0.05). The thyroid volumes of the children in the two groups was measured before and after treatment. Thyroid volume decreased significantly after treatment in both groups, and the thyroid volume was significantly lower in the combined group than in the traditional group (P < 0.05). The serum levels of interleukin-6 (IL-6), IL-8, TRAb, TPOAb and FT4 in the two groups were detected before and after treatment. The levels of IL-6, IL-8, TRAb, TPOAb and FT4 were significantly lower in the combined group than in the traditional group (P < 0.05). Follow-up of the children in the two groups showed that compared with the traditional group, it took less time for children in the combined group to return to the normal level (P < 0.05).

CONCLUSION

Methimazole combined with selenium can effectively treat Graves’ disease in children, reduce the expression of TRAb, TPOAb, FT4 and inflammatory factors, and improve the curative effect. Thus, the combined treatment warrants further clinical research.

Keywords: Methimazole; Selenium; Children; Antithyroid globulin; Anti-thyroid peroxidase antibody

Core Tip: Anti-thyroglobulin (thyroglobulin antibody, TRAb) is a common antibody in the sera of children with autoimmune thyroid disease, and anti-thyroid peroxidase antibody (thyroid peroxidase antibody, TPOAb) is an indicator closely related to thyroid immune damage. In this study, 103 children with Graves’ disease treated in our hospital were selected and divided into a traditional group and a combined group according to treatment method to explore the therapeutic effects of the two methods and to detect changes in serum TRAb and TPOAb levels of the two groups of children before and after treatment. The clinical efficacy of the combined treatment provides a solid theoretical foundation for the clinical diagnosis and treatment of Graves.