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: Gravess 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.
|Graves disease||Hashimoto thyroiditis||Subclinical hyperthyroidism|
|Anthropometric measurements||Height (cm)||153.9±16||156.7±7||157.9±10|
|Physical examination findings||Goiter||Grade 0 (n (%))||15 (24.2%)||2 (22.1%)||3 (60%)|
|Grade I-III||10 (16.1%)||1 (11.1%)||1 (20%)|
|Laboratory findings||At the diagnosis||TSH (uIU/mL)||0.01(0.05)*||0.02±0.008||0.4±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 diagnosis||Propylthiouracil||6.3±3||4.1±2||1.7|
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.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology