International Journal of Clinical Case Reports 2015, Vol.5, No. 36, 1-2
1
A Letter Open Access
Juvenile Hyperthyroidism
Said Azzoug. , Farida Chentli
Endocrine diseases department Bab El Oued Hospital Algiers, Algeria
Corresponding author email
International Journal of Clinical Case Reports, 2015, Vol.5, No.36 doi: 10.5376/ijccr.2015.05.0036
Received: 05 Jul., 2015
Accepted: 06 Aug., 2015
Published: 02 Sep., 2015
Copyright
©
2015 Azzoug S. and Chentli F., This is an open access article published under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Preferred citation for this article:
Azzoug S. and Chentli F., 2015, Juvenile Hyperthyroidism, International Journal of Clinical Case Reports, 5(36) 1
-
2 (doi
Abstract
Background: Hyperthyroidism is less frequent in children than adults and its clinical profile is different.
Objective: The objective of our study was to analyze the clinical characteristics of hyperthyroidism in children and adolescents.
Subjects and Methods: It is a retrospective study concerning 161 patients (129 Females/32 Males) with mean age of 15.63 ±3.51
years. Their medical records were reviewed.
Results: 98.1% have Graves’ disease. Appealing symptoms were thyrotoxicosis signs in 69%, ophtalmological signs in 15% and
goiter in 16%. Diagnosis delay was of 20.73±20.69 months. Clinical presentation was obvious in 81% and discrete in 19%. Goiter
was of type II/type III in 74% and of type I in 26%, exophtalmous was present in 69% and it was severe in 12.5%. Several
complications were recorded, cardiothyreosis in 1.86%, dysglycemia in 13.04%, myopathy in 3.72% and behavioral disorders in
6.83%.
Conclusion: Graves’ disease is the main etiology of hyperthyroidism in children and adolescents; diagnosis is often delayed although
it is clinically obvious so complications may occur. Therefore hyperthyroidism should be diagnosed and treated promptly.
Keywords
Juvenile hyperthyroidism; Graves’ disease; Thyrotoxicosis; Goiter
Introduction
Hyperthyroidism is less frequent in children than
adults, and its clinical profile is different, the aim of
our study was to analyze the clinical characteristics of
hyperthyroidism in children and adolescents.
Material and Methods
It is a retrospective study concerning all patients aged
twenty years or less presenting for hyperthyroidism
during a period of thirty one years [1981-2012]. Their
medical records were reviewed. We analyzed sex ratio,
age at diagnosis, presenting symptoms, etiologies,
complications and treatment modalities.
Results
161 patients were recruited. Sex ratio was of 4
Females/1 Male, mean age at diagnosis was 15.63
3.51 years. Age clusters at diagnosis was as follows,
less than 10 years in 6.9%, between 10 and 16 years in
48.8%, between 16 and 20 years in 44.3%. Diagnosis
delay was of 20.73
20.69 months. Etiologies were as
follows, Graves’ disease in 98.13%, nodular goiter in
1.24% and thyroïditis in 0.63%. Appealing symptoms
were thyrotoxicosis symptoms in 69%, goiter in 16%
and ophtalmological signs in 15%. Clinical
presentation was obvious in 81% and discrete in 19%.
Goiter was of type II/type III in 74% and of type I in
26%. Exophtalmous was present in 69% and was
severe in 12.5%. Complications were as follows,
cardiothyreosis (heart failure) in 1.86%, dysglycemia
in 13.04% (diabetes in 4.34% and prediabetes in
8.70%), myopathy in 3.72% and behavioral disorders
in 6.83%. Treatment was medical using antithyroid
drugs in 68.94%, surgery in 26.1%, radioiodine
treatment in 3.1% and surgery plus radioiodine
treatment in 1.86%.
Discussion
Thyrotoxicosis is rare in children with a frequency of
0.1-3/100 000 person-years (Lavard, 1994)
.
The
majority of patients are diagnosed during puberty as
was in our study where the mean age at diagnosis was
15.63
3.51 years. As in adults, hyperthyroidism
predominates in females. Diagnosis is often delayed
