International Journal of Clinical Case Reports 2015, Vol.5, No. 36, 1-2
2
(Shulman, 1997), in our study, diagnosis delay was of
20.73
20.69 months. Prepubertal children present for
weight loss or frequent stools whereas pubertal
children present for classical signs of thyrotoxicosis as
heat intolerance, irritability, palpitations or for goiter
(Lazar, 2000). As for Lazar (2000) all our patients had
palpable goiters, it was small in 26% and medium to
large in 74%. Graves’ disease is the cause of around
95% of hyperthyroidism in children (Birrell, 2002).
Ophtalmopathy is reported in 25-63% (Chan, 2002), it
was observed in 69% of our patients. The delayed
diagnosis reported earlier may account for the severity
of hyperthyroidism in children as complications were
observed in almost one fourth of our patients.
Remission of Graves’ disease is rare in children
occurring in less than one third of patients after
several years of medical treatment (Bauer, 2011),
so
many patients may require definitive treatment either
surgery or radioiodine treatment.
Conclusion
Hyperthyroidism is rare in children and adolescents as
only 161 cases were recruited during thirty one years.
Although clinical presentation is obvious, diagnosis is
often delayed, which may explain the possible
occurrence of complications even in young patients.
Graves’ disease is the main etiology. Relapsing of
Graves’ disease is frequent in children after
antithyroid drug withdrawal, so many patients require
definitive treatment.
References
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