ESPE Abstracts (2018) 89 P-P3-365

The Reference and Follow-up Signs and Symptoms of the Cases Who Are Diagnosed As Hyperthyroidism

Elif Gokce Demira, Ayla Guvenb,c & Metin Yildiza


aMedeniyet University Goztepe Education and Research Hospital, Pediatric Endocrinology Clinic, Istanbul, Turkey; bSaglik Bilimleri University Zeynep Kamil Maternity and Children Hospital, Pediatric Endocrinology Clinic, Istanbul, Turkey; cGoztepe Education and Research Hospital, Pediatric Endocrinology Clinic, Istanbul, Turkey


Objective: Hyperthyroidism is rarely seen in the childhood. In this study, we evaluated the reference sign and symptoms and following laboratory and treatment results of the hyperthyroidism cases.

Method: Data of the 78 patients were extracted from hospital records retrospectively. Patients’ height, weight, BMI and laboratory results at the time of diagnosis are recorded. Antithyroid drug doses at the 2th, 6th, 12th months after diagnoses are compared to initial treatment doses.

Results: Graves’s disease was detected 79% of the patients. Other causes are Hashimoto tiroiditis, subclinical hyperthyroidism and neonatal hyperthyroidism. Antithyroid drugs are initial treatment in all patients. According to etiology of hyperthyroidism, anthropometric and hormone measurements, antithyroid drug doses were given on the Table 1. Remission is seen in 37 patients. Patients are followed up mean 65±3.7 months. Antithyroid therapy was stopped mean 30.4±14 months later in 22 patients. Hypothyroidism with antithyroid therapy was performed in 46 patients median 2(6) months later and L-thyroxin was added their therapy. Side effects of the antithyroid drugs are seen as urticeria due to methimazole in one patient and the elevation of liver function tests due to propylthiouracil in one patient. Seven patients had relapse. Two patients who have the failure to achieve remission clinically and one patient who has follicular neoplasia suspicion underwent to total thyroidectomy.

Table 1
Graves diseaseHashimoto thyroiditisSubclinical hyperthyroidism
Anthropometric measurementsHeight (cm)153.9±16156.7±7157.9±10
Weight (kg)47.1±1722.7±1049.8±10
BMI19.3±4.117.02±1.619.7±2.3
Physical examination findingsGoiterGrade 0 (n (%))15 (24.2%)2 (22.1%)3 (60%)
Grade I-III10 (16.1%)1 (11.1%)1 (20%)
Laboratory findingsAt the diagnosisTSH (uIU/mL)0.01(0.05)*0.02±0.0080.4±0.1
fT3 (pg/mL)10.9(18.5)*7.4±1.93.6±0.1
fT4 (ng/mL)3.5 (3.8)*2.1 (29.3)*1.01±0.05
Antithyroid drug dose (mg/kg/d)At the diagnosisPropylthiouracil6.3±34.1±21.7
Methimazole0.44±0.20.39±0.2
Propranolol1.1±0.71.11±0.10.5
Final admissionPropylthiouracil6.3±5.23.2±1.0
Methimazole0.3±0.10.59±0.30.19±0.03
Propranolol0.7±0.10.43
L-thyroxin1.4±0.81.22±0.7
*median

Conclusion: In this study, the most common cause of hyperthyroidism is Graves disease that is detected incidentally in one third of the patients. Almost half of the patients achieve remission with antithyroid drug therapy.

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