ESPE2024 Poster Category 3 Thyroid (24 abstracts)
Chief complaints at initial presentation of children with Graves’ disease
Ayse Nurcan Cebeci 1 , Vera Schempp 2 , Katharina Förtsch 3 , Bettina Gohlke 2 , Michaela Marx 1 , Helmuth-Günther Dörr 1 & Joachim Woelfle 1
1Department of Paediatric Endocrinology, Children’s Hospital, Friedrich-Alexander University of Erlangen, Erlangen, Germany. 2Department of Paediatric Endocrinology, Children’s Hospital, University of Bonn, Bonn, Germany. 3Department of Paediatric Endocrinology, Children’s Hospital, University of Düsseldorf, Düsseldorf, Germany
Introduction: Children with Graves' disease (GD) show a set of characteristic clinical symptoms but data describing the chief complaints that led to the initial presentation are rare.
Aims: To evaluate the spectrum of complaints of children with GD at initial presentation.
Patients and Methods: We performed a retrospective review of the medical records of 148 children with biochemically proven GD, diagnosed between 1.1.2004 and 31.12.2021 in three tertiary care centres. We analyzed the complaints that led to the initial presentation for medical care and grouped them into one of the following categories: cardiac, gastrointestinal, goitre, ophthalmologic/neurologic, heat intolerance, and mood/behaviour.
Results: GD was diagnosed at a mean age of 11.9 ± 3.9 (SD) yrs. (range, 1.4-17.8). The female-to-male ratio was 4.5: 1. The complaints could be grouped into the categories gastrointestinal (n = 38), mood/behaviour (n = 37), cardiac (n = 25), heat intolerance (n = 11), goitre (n = 11), and ophthalmologic/neurologic (n = 6). Mood/behaviour complaints (e.g. hyperactivity, fatigue, anxiety, and insomnia) were more common than cardiac complaints. The complaints did not match with the clinical symptoms found at the diagnosis such as goitre (n = 92), weight loss (n = 48), heat intolerance (n = 34), and orbitopathy (n = 24).
Conclusion: Characteristic clinical symptoms of GD such as goitre were not the reason for the initial presentation, whereas complaints associated with mood and behavioural disorders occurred frequently. Clinicians should be aware of these presentations so that hyperthyroidism is diagnosed promptly.
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