Hyperthyroidism In Children

Graves disease is the commonest cause of paediatric hyperthyroidism. Thyroid stimulating receptor antibodies activate the TSH receptor and produce excessive thyroid hormone secretion.

• Weight loss despite increased appetite
• Heat intolerance
• Sweating
• Tremor
• Palpitations
• Tachycardia
• Hyperactivity
• Emotional lability
• Poor concentration
• Goitre
• Accelerated growth
• Eye manifestations in Graves disease

• Suppressed TSH
• Elevated free T4 and or T3
• TSH receptor antibodies support Graves disease

Carbimazole approximately 0.25 to 0.75 mg/kg/day PO, given once or divided depending on regimen and severity, is commonly used.

Monitor thyroid function and titrate.

Warn caregivers about rare but serious agranulocytosis. Fever or sore throat during antithyroid treatment requires stopping the drug and obtaining an urgent FBC until neutropenia is excluded.

Beta blockade can control marked adrenergic symptoms during initial treatment.

Definitive radioactive iodine or surgery may be appropriate for relapse, drug intolerance or selected severe disease.