All cases of the study will be diagnosed as Graves' by History, examination, laboratory (FT3, FT4, TSH \& TRAbs), X-ray on left wrist for bone age, neck grey scale ultrasonography for thyroid gland size, shape, echotexture, vascularity and nodule characters if present with TIRAD score calculation. Then Color flow doppler ultrasound will be done to asses thyroid volume, number of vessels per square cm and inferior thyroid artery peak systolic velocity, end diastolic velocity and resistive index. Patients then will receive carbimazole antithyroid drug at dose 0.25-0.5 mg/kg/day PO \& the dose will be titrated according to thyroid function test after 4-6 weeks. Beta-adrenergic blockade will be added to all symptomatic cases. Regular follow up will be done every month of first 3 months of diagnosis and then every 3 months for 2 years by clinical and thyroid function test to asses response, compliance, complications, drug side effects, remission and relapses. Doppler ultrasound will be done at 0, 12 and 24 months.
Study Type
OBSERVATIONAL
Enrollment
32
thyroid volume
Time frame: 3 years
number of vessels per square cm of thyroid gland
Time frame: 2 years
inferior thyroid artery peak systolic velocity
Time frame: 2 years
end diastolic velocity
Time frame: 2 years
resistive index
Time frame: 2 years
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