Graves’ Disease in Children: An Update

Abstract

Graves’ disease (GD) is the most common cause of hyperthyroidism in children. A common GD symptom is a goiter. The usual biochemical profile in children with GD is a decreased thyroid hormone stimulating hormone (TSH) level and high free thyroxine (FT4) and free triiodothyronine (FT3) concentrations. The presence of thyroid receptor antibodies (TRAb) is the most important specific immunological sign for diagnosing GD. The treatment choices for pediatric GD are anti-thyroid drugs (ATDs), radioiodine, and thyroidectomy, but the risks and benefits of each modality are different. Management recommendations include the first-line use of a prolonged course of ATDs for at least 3 years and potentially 5 years or more. Rituximab and Teprotumumab are new novel alternative medications for the treatment of adult patients with GD and Graves’ orbitopathy respectively, but evidence of the efficacy and safety of these drugs in pediatric patients with GD is lacking.

Diagnosis of Graves’ Disease and Methimazole-Induced Lupus Erythematosus in an Adolescent Male During the COVID-19 Era: A Case Report

“…In the pediatric population, GD may present with tachycardia, diarrhea, or increased appetite with or without weight loss. Other symptoms such as poor exercise tolerance, poor sleep, emotional lability, and moodiness are often misinterpreted as normal problems affecting school-aged children [ 5 ]. In some cases, hyperthyroidism has been associated with tall stature, rapid bone maturation, and exophthalmos.…”