Management of hyperthyroidism in children

Abstract

Treatment of hyperthyroidism in children differs according to its etiology; in particular, the optimal therapy of Graves' disease (GD) remains a matter of debate and there is currently no evidence-based therapeutic strategy that is universally adopted in all the countries. Areas covered: The most recent treatment strategies in the different pediatric conditions which may be associated with hyperthyroidism. We searched PubMed and Cochrane (1990 to 2016) in order to identify articles to include in this review using the following terms: Hyperthyroidism, Childhood, Antithyroid drug therapy, Thyroidectomy, Radioactive iodine. Expert commentary: Although pharmacological therapy represents the first-line approach for GD children, we recommend to individualize, as much as possible, the overall therapeutic approach, with no prejudices towards radical therapies, particularly in the cases with frequent relapses. Clinical and laboratory preferential criteria for an individualized therapeutic approach to GD children are given. Treatment procedures for hyperthyroid children without GD are also discussed.

Genetics of Thyroid Disorders

“…Neonatal Graves' is treated with a β-blocker (propranolol 1-2 mg/kg/day divided into four doses) for symptomatic relief and MMI (0.5-1 mg/kg/day divided into three doses) is the antithyroid medication of choice over PTU given PTU's higher risk for hepatotoxicity [55,57,58].…”

Alteraciones tiroideas en la infancia y en la adolescencia. Parte 1: hipertiroidismo Comité Nacional de Endocrinología

“…4 Las causas pediátricas de hipertiroidismo se enumeran en la Tabla 1; la más frecuente es la enfermedad de Graves (EG), que corresponde al 84 % de los casos. 5,6…”