Hyperthyroidism in Children and Adolescents

Zimmerman, Donald; Gan-Gaisano, Margaret

doi:10.1016/s0031-3955(16)37011-0

Cited by 43 publications

(40 citation statements)

References 134 publications

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“…La causa más comúnmente descrita de HT es la enfermedad de Graves (95%) 14 , en nuestro estudio correspondió sólo al 73% de los casos; esto pudiera explicarse porque en 3 pacientes no se pudo precisar la etiología del HT. Otras causas son la tiroiditis linfocitaria crónica que en su fase inicial produce liberación de hormonas tiroideas por destrucción celular (Hashitoxicosis) 15 , que correspondió en nuestros niños al 15,3% de las etiologías; se ha descrito también HT inducido por yodo, Síndrome de McCune-Albright, cán-cer de tiroides, hipersecreción de TSH e inges-tión de hormonas tiroideas 16 . El HT neonatal puede ocurrir en hijos de madre con EG, el cual es transitorio o ser secundario a HT congénito no autoinmune.…”

Section: Discussionunclassified

Hipertiroidismo en niños y adolescentes

et al. 2009

Rev. chil. pediatr.

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Hyperthyroidism in children and adolescentsBackground: Hyperthyroidism (HT) prevalence is 0.1/100,000 children and 1/100,000 adolescents and Graves Disease is the most frequent etiology. Objective: To evaluate the clinical presentation, etiology and treatment in hyperthyroid children. Method: Retrospective review of clinical charts of children under 15 years-old, between June 2004 and August 2005. Hyperthyroidism diagnosis was performed with suppressed TSH and increased thyroid hormones levels. Etiological study was done by TRAb, ATPO, ATG, thyroid echotomography and I

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Section: Discussionunclassified

Hipertiroidismo en niños y adolescentes

et al. 2009

Rev. chil. pediatr.

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“…Relapse was defined as suppressed TSH levels (!0.05 mIU/l) combined with serum fT 4 concentrations O21 pmol/l or fT 3 concentrations O8 pmol/l, after the discontinuation of ATD treatment.…”

Section: Study Protocolmentioning

confidence: 97%

“…It is uncommon in children, who account (ATD) treatment is usually recommended as the first-line treatment and is generally well tolerated. The disease seems to be more severe in children than in adults, with a higher overall frequency of relapse, and remission achieved in only 30% of children, vs 40-60% of adults, following a first course of treatment lasting about 2 years (3,4,5,6,7,8,9,10,11). We have recently shown that more prolonged medical treatment may increase remission rates to 50% in children (12).…”

Section: Introductionmentioning

confidence: 97%

“…The clinical diagnosis of GD is generally straightforward and hyperthyroidism is confirmed by high serum free thyroxine (fT 4 ) and free triiodothyronine (fT 3 ) levels, with TSH undetectable in the serum (!0.05 mIU/l). However, some patients may have high serum fT 3 levels with paradoxically normal or even low fT 4 levels during the course of the disease.…”

Section: Introductionmentioning

confidence: 99%

“…However, some patients may have high serum fT 3 levels with paradoxically normal or even low fT 4 levels during the course of the disease. This condition, known as T 3 -predominant GD (T 3 -P-GD) or T 3 -toxicosis, is well known in adults and may be observed after diagnosis of relapse (10,13). T 3 -P-GD has been shown to be associated with very high titers of serum TSH receptor autoantibodies (TRAb) and large goiters in adults, but its pathogenesis remains unclear (14).…”

Section: Introductionmentioning

confidence: 99%

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Triiodothyronine-predominant Graves' disease in childhood: detection and therapeutic implications

Harvengt

Boizeau

Chevenne

et al. 2015

European Journal of Endocrinology

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Objective: To assess in a pediatric population, the clinical characteristics and management of triiodothyronine-predominant Graves' disease (T 3 -P-GD), a rare condition well known in adults, but not previously described in children. Design: We conducted a university hospital-based observational study. Methods: All patients with GD followed for more than 1 year between 2003 and 2013 (nZ60) were included. T 3 -P-GD (group I) was defined as high free T 3 (fT 3 ) concentration (O8.0 pmol/l) associated with a normal free thyroxine (fT 4 ) concentration and undetectable TSH more than 1 month after the initiation of antithyroid drug (ATD) treatment. Group II contained patients with classical GD without T 3 -P-GD. Results: Eight (13%) of the patients were found to have T 3 -P-GD, a median of 6.3 (3.0-10.5) months after initial diagnosis (nZ4) or 2.8 (2.0-11.9) months after the first relapse after treatment discontinuation (nZ4). At GD diagnosis, group I patients were more likely to be younger (6.8 (4.3-11.0) vs 10.7 (7.2-13.7) years) and had more severe disease than group II patients, with higher serum TSH receptor autoantibodies (TRAb) levels: 40 (31-69) vs 17 (8-25) IU/l, P!0.04, and with slightly higher serum fT 4 (92 (64-99) vs 63 (44-83) pmol/l) and fT 3 (31 (30-46) vs 25 (17-31) pmol/l) concentrations. During the 3 years following T 3 -P-GD diagnosis, a double dose of ATD was required and median serum fT 4 :fT 3 ratio remained lower in group I than in group II. Conclusion: Severe hyperthyroidism, with particularly high TRAb concentrations at diagnosis, may facilitate the identification of patients requiring regular serum fT 3 determinations and potentially needing higher doses of ATD dosage during follow-up.

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The Development of Thyroid Storm in a Child With McCune-Albright Syndrome After Orthopedic Surgery

Lawless¹

1992

Arch Pediatr Adolesc Med

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Hyperthyroidism in Children and Adolescents

Cited by 43 publications

References 134 publications

Hipertiroidismo en niños y adolescentes

Hipertiroidismo en niños y adolescentes

Triiodothyronine-predominant Graves' disease in childhood: detection and therapeutic implications

The Development of Thyroid Storm in a Child With McCune-Albright Syndrome After Orthopedic Surgery

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