Graves disease (GD) is the most common cause of hyperthyroidism in children and adolescents. Three treatment options are available in pediatric GD. These treatment options include antithyroid drugs (ATD) therapy with methimazole, radioiodine (RAI) therapy and surgery or thyroidectomy. Only 30% of patients achieved remission with ATD therapy. Relapse of GD during treatment and after remission are frequently found and need longer duration of ATD treatment for euthyroidism. Acquired hypothyroidism with life-long thyroxine replacement commonly found following RAI therapy and surgery. The choices for modalities of treatment are individualized, depend on age of patients, severity of GD, goiter size, and parental preference.
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