Comparison of Thyrotropin Receptor Antibodies Levels Before and After Methimazole Therapy for 6 months in Children With Graves Disease

Background : Graves’ disease is the leading cause of hyperthyroidism in children. The increase of hormones thyroxine (T4), free thyroxine (fT4) and triiodothyronine (T3) in Graves' disease is caused by the presence of thyroid stimulating antibodies (TSHR-Ab) or Thyrotopin receptor antibodies (TRAb). Methimazole (MMI) is often use as anti thyroid medication in children. Methimazole therapy may give a good response to patients with new-onset Graves’ disease, high levels of thyroxine, high TRAb), and no or small goiters. Objective : The purpose of this study was to determine the differences in TRAb before and after Methimazole Therapy for 6 months in children with Graves’ disease. Method : Retrospective study on 28 children below 18 year old with Graves’ disease at H. Adam Malik General Hospital Medan with TRAb, fT4, TSH data collection before and after Methimazole therapy for 6 months taken from medical records. Result : Median age 11.85 ± 3.73 with the number of women 85.7% compared to men 14.3%. The median value before Methimazole therapy was TRAb 32,11 IU/L, fT4 3.56 ng/dl and TSH 0.01 mU/l. Median values after 6 months of Methimazolee therapy were TRAb 17.15 IU/L, fT4 1.51 ng/dl and TSH 0.51 mU/l with P values <0.001, P = 0.006, P <0.001 respectively. Conclusion: There was significant differences in TRAb, fT4, and TSH median values before and after 6 months of Methimazole therapy in children with Graves’ disease.