Background: Hyperthyroidism is considered to be rare in children; its clinical profile is different and the most cause is Graves disease (GD).
Objective and hypotheses: To evaluate clinical features and evolution of childhood hyperthyroidism.
Method: Longitudinal retrospective study of patients diagnosed with hyperthyroidism.
Results: 8 cases were identified between 2006 and 2013: 6F/2M, the patients average age at diagnosis was 12.8 (range 1015) years in seven patients and one at 2 days of live, diagnosis delay was 6 days of live in a neonate, and at median 3 (range 18) months in seven patients, appearing symptoms were thyrotoxicosis signs and goiter in seven cases,ophthalmological signs in four cases; in the laboratory evaluation, we highlight: TSH suppression in all patients, raised free T4 in all patients; Trab were elevated in six cases, elevated title of antiperoxidase were found in seven patients. There were six cases with GD, one case with Hashimotos thyroiditis who presented type1 DM, and one case with neonatal thyrotoxicosis who is severely affected. All patients received Carbimazol (CM); four patients have been treated for more than 2 years, one patient was treated surgically after one year of treatment with CM, the reasons for alternative treatment were very large goiter and poor compliance. Relapse was observed in two cases in which treatment was stopped at 24 months. We observed healing at 3 months of age for neonatal thyrotoxicosis and remission in two cases.
Conclusion: Rather high rate of relapse is observed in GD; stop antithyroid medication after 24 months is usually unsui is usually unsuccessful particularly in prepubertal children. Poor compliance with treatment and drug side and drug side effects may also lead to consideration of radioiodine treatment or surgery; the maisurgery; the main advantage of surgery is the rapid cure of the thyrotoxicosis. Radioiodine therapy still controversial in children before 10 years of age.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology