Hyperthyroidism

Hyperthyroidism in children and adolescents was primarily caused by Graves disease, an autoimmune disorder linked to specific HLA haplotypes, with a higher prevalence in girls and a peak incidence at ages 11 to 15. Symptoms included behavioral disturbances, cardiovascular issues, and weight loss despite increased appetite. Diagnosis was confirmed by elevated T4 and suppressed TSH levels, with TRAbs present in 95% of cases. Treatment options included antithyroid medications, radioiodine therapy, and surgical thyroidectomy, each with varying success rates and potential complications. Antithyroid drugs were often the first line of treatment, though long-term remission was achieved in only 30% to 40% of cases. Radioiodine therapy had a high cure rate but often resulted in hypothyroidism, which was considered a treatment goal to reduce relapse and cancer risk. Surgical options were reserved for specific cases and carried risks of complications. Lifelong follow-up was necessary for all patients. Additionally, maternal Graves disease posed risks for neonatal thyrotoxicosis, with potential long-term effects on the child.