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April 1951

TREATMENT OF TOXIC DIFFUSE GOITER (GRAVES'S DISEASE) IN CHILDHOOD: Report of a Case Successfully Treated with Propylthiouracil

Author Affiliations

From the Pediatric Service of Dr. Horace L. Hodes, Mount Sinai Hospital.

AMA Am J Dis Child. 1951;81(4):556-562. doi:10.1001/archpedi.1951.02040030567011

In previous publications1 it was pointed out that although surgery may be the best procedure in treating toxic diffuse goiter in adults, conservative management is recommended when the condition occurs before puberty. A report was given of eight children who had been treated medically and who after a follow-up period of from 3½ to 25 years were all entirely well.

The points in favor of the medical treatment of toxic diffuse goiter may be briefly summarized. 1. Operative mortality, although concededly low since the advent of iodine, is ever present, whereas no reports of death among medically treated children are to be found in the literature. 2. Even the most enthusiastic advocates of surgery admit that postoperative complications and sequelae are more frequent in children than in adults. Secondary hemorrhage, wound sepsis with extending mediastinitis, pneumonia, pulmonary collapse, postoperative tetany, postoperative crisis and laryngeal nerve injury with vocal cord

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