Hyperthyroidism

Question 1

What is the most common cause of hypothyroidism in children?

Answer 1

Grave’s disease found in 1 in 100,000

Question 2

Who is commonly affected?

Answer 2

Young adolescent girls

Question 3

What is Grave’s disease?

Answer 3

autoimmune condition in which TSH receptor antibodies bind to the TSH receptors on the thyroid and stimulate thyroxine release.

Question 4

What instances can cause congenital hyperthyroidism?

Answer 4

This can occur in babies born to mothers with hyperthyroidism due to high levels of maternal TSH receptor antibodies crossing the placenta

Question 5

What may a child with hyperthyroidism present with?

Answer 5

1. Tall stature or advanced bone age
2. No affect on puberty but can cause secondary amenorrhea
3. ADHD symptoms

Question 6

How can hyperthyroidism be diagnosed?

Answer 6

1. High thyroxine and low TSH levels

2. Presence of TSH receptor antibodies confirms Grave’s disease

Question 7

First line management of hyperthyroidism?

Answer 7

1. Carbimazole to limit the production of thyroid hormone

Question 8

Second line management of hyperthyroidism?

Answer 8

1. Radioactive iodine - absorbed by thyroid gland and manages it to prevent thyroid hormone production.
2. Surgical resection of thyroid gland - occurs in most cases as children below 5 are contraindicated for iodine tx

Question 9

What is the prognosis of hyperthyroidism?

Answer 9

All patients require lifelong monitoring of thyroid function as are highly susceptible to developing secondary hypothyrodism as a result of treatment.