Update on Pediatric Hyperthyroidism

Adv Pediatr. 2022 Aug;69(1):219-229. doi: 10.1016/j.yapd.2022.04.004. Epub 2022 Jun 20.

Abstract

Typical symptoms which should lead to suspicion of hyperthyroidism are unintentional weight loss, tachycardia, and palpitations, heat intolerance, and hyperactivity. It is diagnosed by suppressed thyroid-stimulating hormone (TSH) with elevated thyroid hormone (TH) levels. Graves' disease (GD) due to antibodies stimulating the TSH receptor is the leading cause, and first-line treatment is with methimazole (MMI). Emerging data suggest MMI treatment, up to 8 years is effective and safe in improving the rate of remission. Radioactive iodine (RAI) and thyroidectomy offer definitive treatment and induce permanent hypothyroidism. Thyroid storm is a life-threatening condition with systemic decompensation and hyperpyrexia. Neonates of mothers with current or past GD are at risk for neonatal hyperthyroidism (NH). Appropriate identification and follow-up of at-risk neonates will reduce complications.

Keywords: Graves’ disease; Hyperthyroidism in children; Neonatal hyperthyroidism.

Publication types

  • Review

MeSH terms

  • Child
  • Graves Disease* / complications
  • Graves Disease* / diagnosis
  • Graves Disease* / therapy
  • Humans
  • Hyperthyroidism* / diagnosis
  • Hyperthyroidism* / epidemiology
  • Hyperthyroidism* / therapy
  • Infant, Newborn
  • Iodine Radioisotopes / therapeutic use
  • Methimazole / therapeutic use
  • Thyroid Neoplasms*

Substances

  • Iodine Radioisotopes
  • Methimazole