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Meihua Jin Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine and School of Medicine, Seoul, Republic of Korea

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Ahreum Jang Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
Division of Endocrinology and Metabolism, Department Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea

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Chae A Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Tae Yong Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Won Bae Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Young Kee Shong Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Min Ji Jeon Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Won Gu Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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gland ( 1 , 2 ). Current treatment options for patients with Graves’ hyperthyroidism include antithyroid drugs (ATDs), radioactive iodine (RAI) therapy, and surgery ( 1 , 3 , 4 ). Although geographical difference exists, ATD is the preferred first

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J Karmisholt Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Institute, Aalborg University, Aalborg, Denmark

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S L Andersen Department of Clinical Institute, Aalborg University, Aalborg, Denmark
Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark

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I Bulow-Pedersen Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Institute, Aalborg University, Aalborg, Denmark

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A Krejbjerg Department of Oncology, Aalborg University Hospital, Aalborg, Denmark

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B Nygaard Department of Endocrinology and Internal Medicine, Herlev University Hospital, Copenhagen, Denmark

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A Carlé Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Institute, Aalborg University, Aalborg, Denmark

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Primers 2020 6 52. ( https://doi.org/10.1038/s41572-020-0184-y ) 3 Abraham P Avenell A McGeoch SC Clark LF Bevan JS . Antithyroid drug regimen for treating Graves’ hyperthyroidism . Cochrane Database of Systematic Reviews 2010 2010 CD003420

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Marta Nascimento Soares Faculty of Medicine of the University of Porto, Porto, Portugal

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Marta Borges-Canha Faculty of Medicine of the University of Porto, Porto, Portugal
Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
Department of Surgery and Physiology, Cardiovascular Research Unit, Faculty of Medicine from the University of Porto, Porto, Portugal

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Celestino Neves Faculty of Medicine of the University of Porto, Porto, Portugal
Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
Institute for Research Innovation in Health, University of Porto, Porto, Portugal

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João Sérgio Neves Faculty of Medicine of the University of Porto, Porto, Portugal
Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
Department of Surgery and Physiology, Cardiovascular Research Unit, Faculty of Medicine from the University of Porto, Porto, Portugal

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Davide Carvalho Faculty of Medicine of the University of Porto, Porto, Portugal
Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
Institute for Research Innovation in Health, University of Porto, Porto, Portugal

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, smoking habits, treatment for Graves’ disease (type of antithyroid drug, maximum dose, duration and number of iodine ablative doses, and thyroidectomy), diagnosis of ophthalmopathy, diagnosis of dermopathy, thyroid ultrasound results, results of biopsies

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Yiyun Cui Department of Endocrinology, Children's Hospital of Nanjing Medical University, Nanjing, China

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Jinlong Chen Department of Cardiology, Children's Hospital of Nanjing Medical University, Nanjing, China

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Rui Guo Department of Endocrinology, Children's Hospital of Nanjing Medical University, Nanjing, China

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Ruize Yang Department of Public Health, Children's Hospital of Nanjing Medical University, Nanjing, China

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Dandan Chen Department of Endocrinology, Children's Hospital of Nanjing Medical University, Nanjing, China

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Wei Gu Department of Endocrinology, Children's Hospital of Nanjing Medical University, Nanjing, China

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Francis Manyori Bigambo School of Public Health, Nanjing Medical University, Nanjing, China

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Xu Wang Department of Endocrinology, Children's Hospital of Nanjing Medical University, Nanjing, China

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Introduction Graves' disease (GD) in children has attracted worldwide attention. Antithyroid drug (ATD) has been recommended by 2022 European Thyroid Association Guideline as the first-line therapy for GD children ( 1 ). Since propylthiouracil

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Stefan Matei Constantinescu Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Bruxelles, Belgium

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Julien Hospel Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Bruxelles, Belgium

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Chantal Daumerie Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Bruxelles, Belgium

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Orsalia Alexopoulou Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Bruxelles, Belgium

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Dominique Maiter Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Bruxelles, Belgium

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Maria-Cristina Burlacu Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Bruxelles, Belgium

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. Journal of Clinical Endocrinology and Metabolism 1989 68 1097 – 1100 . ( https://doi.org/10.1210/jcem-68-6-1097 ) 12 Katahira M & Ogata H . Thyroglobulin autoantibodies are associated with refractoriness to antithyroid drug treatment for Graves

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Mats Holmberg ANOVA, Karolinska University Hospital, Norra Stationsgatan 69, Stockholm, Sweden
Institute of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
Wallenberg’s Centre of Molecular and Translational Medicine, Region Västra Götaland, Sweden

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Helge Malmgren Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden

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Peter F Berglund Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden

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Birgitta Johansson Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden

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Helena Filipsson Nyström Wallenberg’s Centre of Molecular and Translational Medicine, Region Västra Götaland, Sweden
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
Department of Endocrinology, Sahlgrenska University Hospital, Göteborg, Sweden
Gothenburg Centre for Person Centred-Care (GPCC), Göteborg, Sweden

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with the local treatment scheme for premenopausal female adult patients with GD where all patients received either antithyroid drugs (ATD) or surgery with previous ATD treatment. As an exception, one patient was treated with radioactive iodine

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Agneta Lindo Department of Endocrinology, Sahlgrenska University Hospital, Göteborg, Sweden
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
The National Task Force in Hyperthyroidism, Swedish National System for Knowledge-Driven Management, Umeå, Sweden

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Anne Breikert The National Task Force in Hyperthyroidism, Swedish National System for Knowledge-Driven Management, Umeå, Sweden
Department of Endocrinology and Diabetes, Örebro University Hospital, Örebro, Sweden

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Peter Lakwijk The National Task Force in Hyperthyroidism, Swedish National System for Knowledge-Driven Management, Umeå, Sweden
Thyroid Federation International, Kungsbacka, Sweden

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Christin Lundberg The National Task Force in Hyperthyroidism, Swedish National System for Knowledge-Driven Management, Umeå, Sweden
Swedish Thyroid Association, Stockholm, Sweden

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Katarina Lunner The National Task Force in Hyperthyroidism, Swedish National System for Knowledge-Driven Management, Umeå, Sweden
Swedish Thyroid Association, Stockholm, Sweden

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Birgitta Johansson Institute of Neuroscience and Physiology Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden

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Helena Filipsson Nyström Department of Endocrinology, Sahlgrenska University Hospital, Göteborg, Sweden
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
The National Task Force in Hyperthyroidism, Swedish National System for Knowledge-Driven Management, Umeå, Sweden
Sweden and Wallenberg Center for Molecular and Translational Medicine, Västra Götaland Region, Göteborg, Sweden

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. A New Zealand study ( 14 ) has examined the level of patient preference in determining which type of treatment to proceed with. The most important factors for choosing therapy between antithyroid drugs (ATDs), surgery, or radioactive iodine (RAI

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Caiyan Mo Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

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Han Chen Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

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Qi Zhang Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

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Ying Guo Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

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Liyong Zhong Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

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function change, and treatment of case 1. ATD, antithyroid drugs; FT3, free tri-iodothyronine; FT4, free thyroxine; SSA, somatostatin analog; TRAb, thyroid-stimulating hormone receptor antibodies; TSH, thyroid-stimulating hormone; TSS, transsphenoidal

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Megumi Fujikawa Fujikawa-Megumi Clinic, Mizutani 2-7-7, Higashi-ku, Fukuoka, Japan
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, Japan

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Ken Okamura Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, Japan

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high prevalence of insufficient decline or re-elevation of thyroid hormone levels, the so-called ‘escape phenomenon from the Wolff-Chaikoff effect’ ( 7 , 8 ), was observed. Since the introduction of thionamide antithyroid drugs ( 9 ), the use of iodide

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Birgitta Johansson Department of Clinical Neuroscience, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden

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Mats Holmberg ANOVA, Karolinska University Hospital, Norra Stationsgatan 69, Stockholm, Sweden
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Wallenberg’s Centre of Molecular and Translational Medicine, Region Västra Götaland, Sweden

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Simon Skau Department of Clinical Neuroscience, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
Department of Pedagogical, Curricular and Professional Studies, Faculty of Education, University of Gothenburg, Gothenburg, Sweden

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Helge Malmgren Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

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Helena Filipsson Nyström Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Wallenberg’s Centre of Molecular and Translational Medicine, Region Västra Götaland, Sweden
Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden

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included from September 2011 to October 2019 at the Department of Endocrine Research, Sahlgrenska University Hospital, Gothenburg, Sweden. Patients were included within 2 weeks after starting treatment with antithyroid drugs (ATD, thiamazole). All patients

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