ESPE Abstracts

Introduction: Graves’ diseases is a rare autoimmune disease in children. Viral infections are considered as a trigger for autoimmune thyroid disorders. A temporal association between SARS-CoV-2 and a novel pediatric hyperinflammatory condition called Paediatric inflammatory multisystem syndrome has been reported in 2020, raising questions about the link between SARS-CoV-2 and autoimmune and autoinflammatory diseases. Over the last year (2021), we noticed an increase in the number of children presenting to our department with Graves’ disease. Our primary aim is to document the incidence of Graves’ disease in our department since 2005, comparing our data with national data regarding thiamazol delivery. Our secondary aim is to compare the characteristics of the patients diagnosed before and during the SARS-CoV-2 outbreak.

Material and methods: A retrospective study including all the pediatric patients diagnosed with Graves’ disease seen in our department since 2005 was performed. Hyperthyroid newborns were excluded. Data collected were the date and the age at diagnosis, the thyroid hormone levels, TSI at diagnosis, data from the national health insurance regarding the number of delivered thyroid hormone synthesis inhibitor drugs, thiamazol, in children (<18 years)/year.

Results: A total of 48 patients with Graves’ disease were diagnosed since 2005 in our department. Fifteen patients (1/3) were diagnosed since the SARS-CoV-2 outbreak, with the highest incidence in 2021 (11 patients). At the national level, an increase of thiamazol delivery is observed in 2020 and 2021 compared to the preceding years. Similar results regarding the age of diagnosis, free T4 and T3 levels or the presence of auto-immune diseases in the personal or family history were observed between the patients diagnosed before and those diagnosed during the SARS-CoV-2 outbreak.

Conclusions: We observed a temporal association between SARS-CoV-2 outbreak and an increase in pediatric Graves’ disease. The age and severity of the disease seems not to be influenced by the SARS-CoV-2 outbreak. SARS-CoV-2 could thus constitute a trigger for pediatric Graves’ disease. Further studies are needed to confirm our findings.