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Graves’ Disease in Fourteen Years Old Girl

Received: 5 November 2020    Accepted: 18 November 2020    Published: 4 December 2020
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Abstract

Graves’ disease (GD), an autoimmune disorder resulting from thyrotropin (TSH) receptor stimulation by autoantibodies, is an uncommon disease in children. The incidence of GD is thought to be rising and is currently about 0.1 per 100,000 person-years in young children to 3 per 100,000 person-years in adolescents. The estimated prevalence varies between countries, from 1/10,000 in the United States to 1/100,000 person-years (for children aged 0–15 years) in the UK and Ireland. We reported one female patient, 14 years old, complained neck lump accompanied by exophthalmos, palpitation especially at night, followed by easily sweating all over her body. That manifestation also followed by increased of appetite, sleep disturbance, agitated, and behavioural changes those affecting her school report. Physical examination revealed hypertension, tachycardia, proptosis of both eyes, a non-pain palpable soft diffuse symmetrical mass on front neck followed down when swallowing, a systolic murmur, sweating on palms and soles of the feet. Laboratorium investigation was found FT4 >100,000 ng/dL (0.93-1.70); TSHs <0.05 IU/mL (0.27-4.20); T3 Total 28.6 nmol/L; TRAb 36.5 IU/L (≤1.75) and an ECG result found sinus tachycardia. Patient was treated with thyrozol (thiamazole) and propranolol. We need to increase awareness to adverse event of antihyperthyroid drugs, remission rate, predictor factors in successful treatment to get a better long-term outcomes of medical therapy in Grave’s disease.

Published in American Journal of Pediatrics (Volume 6, Issue 4)
DOI 10.11648/j.ajp.20200604.25
Page(s) 476-480
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Graves’ Disease, Hyperthyroidism, Thyrotoxicosis

References
[1] Leger J, Kaguelidou F, Alberti C, Carel J. C. (2014). Graves’ disease in children. Best Practice & Research Clinical Endocrinology & Metabolism 28: 233-243.
[2] Gastaldi R, Poggi E, Mussa A. (2014). Graves disease in children: Thyroid-stimulating hormone receptor antibodies as remission markers. The Journal of Pediatrics 1-8.
[3] Leger J, Oliver I, Rodrigue D, Lambert A, Coutant R. (2018). Graves’ disease in children. Annales d’Endocrinologie 79: 647-655.
[4] Minamitani K, Sato H, Ohye H, Harada S, Arisaka O. (2017). Guidelines for the treatment of childhood-onset Graves’ disease in Japan, 2016. Clin Pediatr Endocrinol 26 (2): 29-62.
[5] John M, Sundrarajan R, Gomadam S. (2015). Anti-thyroid drugs in pediatric graves disease. Indian J Endocrinol Metab 19 (3): 340-6.
[6] Lanas A, Diza P, Eugenin D, Gonzalez F, Cid P, Cordero F. (2017). Clinical features of patients with basedow grave’s disease seen at a university hospital. Rev Med Chil 145 (4): 436-440.
[7] Boiro D, Ciedhiou D, Niang B, Sow D, Mbodi M, Sarr A. (2017). Hyperthyroidism in children at university hospital in Dakar, Senegal. Pan Afr Med 28 (10); 1-5.
[8] Yasuda K, Miyoshi Y, Tachibana M, Namba N, Miki K, Nakata Y. (2017). Relationship between dose of hyperthyroid drugs and adverse events in pediatric patients with grave’s disease. Clin Pediatr Endocrinol 26 (1): 1-7.
[9] Leger J, Carel C. (2017). Management of endocrine disease: Arguments for the prolonged use of antithyroid drugs in children with grave’s disease. Eur J Endocr 177: R59-67.
[10] Chiang Y, Ting W, Huang C, Huang S, Chan C, Cheng B, et al. (2020). Long-term outcomes of graves disease in children treated with anti-thyroid drugs. Pediatrics and Neonatology 61: 311-317.
[11] Choi Y. J., Jang J. H., Park S. H., Oh J. H., Koh D. K. (2016). Dilated cardiomyopathy with grave’s disease in a young child. Ann Pediatr Endocrinol Metab 21: 92-5.
[12] Elfenbein D. M., Katz M, Schneider D. F., Chen H, Sippel R. S. (2016). Thyroidectomy for grave’s disease in children: Indications and complications. J Pediatr Surg 51 (10): 1680-3.
[13] Singh A, Purani C, Mandal A, Mehariya K, Das R. R. (2016). Prevalence of thyroid disorders in children at a tertiary care hospital in western India. J Clin Diagn 10 (2): SC01-4.
[14] Sanyal D, Chatterjee S. (2015). Hyperthyroidism in children: Treatment outcomes and preference in Eastern India. Clin Pediatr Endocriol 24 (2): 65-6.
[15] Batubara, Jose R. L. Buku Ajar Endokrinologi Anak, 1st ed., Badan Penerbit IDAI: Jakarta, 2010, pp. 250-300.
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  • APA Style

    I Gusti Ayu Prema Yani Sidemen, I Made Arimbawa. (2020). Graves’ Disease in Fourteen Years Old Girl. American Journal of Pediatrics, 6(4), 476-480. https://doi.org/10.11648/j.ajp.20200604.25

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    ACS Style

    I Gusti Ayu Prema Yani Sidemen; I Made Arimbawa. Graves’ Disease in Fourteen Years Old Girl. Am. J. Pediatr. 2020, 6(4), 476-480. doi: 10.11648/j.ajp.20200604.25

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    AMA Style

    I Gusti Ayu Prema Yani Sidemen, I Made Arimbawa. Graves’ Disease in Fourteen Years Old Girl. Am J Pediatr. 2020;6(4):476-480. doi: 10.11648/j.ajp.20200604.25

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  • @article{10.11648/j.ajp.20200604.25,
      author = {I Gusti Ayu Prema Yani Sidemen and I Made Arimbawa},
      title = {Graves’ Disease in Fourteen Years Old Girl},
      journal = {American Journal of Pediatrics},
      volume = {6},
      number = {4},
      pages = {476-480},
      doi = {10.11648/j.ajp.20200604.25},
      url = {https://doi.org/10.11648/j.ajp.20200604.25},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20200604.25},
      abstract = {Graves’ disease (GD), an autoimmune disorder resulting from thyrotropin (TSH) receptor stimulation by autoantibodies, is an uncommon disease in children. The incidence of GD is thought to be rising and is currently about 0.1 per 100,000 person-years in young children to 3 per 100,000 person-years in adolescents. The estimated prevalence varies between countries, from 1/10,000 in the United States to 1/100,000 person-years (for children aged 0–15 years) in the UK and Ireland. We reported one female patient, 14 years old, complained neck lump accompanied by exophthalmos, palpitation especially at night, followed by easily sweating all over her body. That manifestation also followed by increased of appetite, sleep disturbance, agitated, and behavioural changes those affecting her school report. Physical examination revealed hypertension, tachycardia, proptosis of both eyes, a non-pain palpable soft diffuse symmetrical mass on front neck followed down when swallowing, a systolic murmur, sweating on palms and soles of the feet. Laboratorium investigation was found FT4 >100,000 ng/dL (0.93-1.70); TSHs <0.05 IU/mL (0.27-4.20); T3 Total 28.6 nmol/L; TRAb 36.5 IU/L (≤1.75) and an ECG result found sinus tachycardia. Patient was treated with thyrozol (thiamazole) and propranolol. We need to increase awareness to adverse event of antihyperthyroid drugs, remission rate, predictor factors in successful treatment to get a better long-term outcomes of medical therapy in Grave’s disease.},
     year = {2020}
    }
    

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    AU  - I Gusti Ayu Prema Yani Sidemen
    AU  - I Made Arimbawa
    Y1  - 2020/12/04
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    AB  - Graves’ disease (GD), an autoimmune disorder resulting from thyrotropin (TSH) receptor stimulation by autoantibodies, is an uncommon disease in children. The incidence of GD is thought to be rising and is currently about 0.1 per 100,000 person-years in young children to 3 per 100,000 person-years in adolescents. The estimated prevalence varies between countries, from 1/10,000 in the United States to 1/100,000 person-years (for children aged 0–15 years) in the UK and Ireland. We reported one female patient, 14 years old, complained neck lump accompanied by exophthalmos, palpitation especially at night, followed by easily sweating all over her body. That manifestation also followed by increased of appetite, sleep disturbance, agitated, and behavioural changes those affecting her school report. Physical examination revealed hypertension, tachycardia, proptosis of both eyes, a non-pain palpable soft diffuse symmetrical mass on front neck followed down when swallowing, a systolic murmur, sweating on palms and soles of the feet. Laboratorium investigation was found FT4 >100,000 ng/dL (0.93-1.70); TSHs <0.05 IU/mL (0.27-4.20); T3 Total 28.6 nmol/L; TRAb 36.5 IU/L (≤1.75) and an ECG result found sinus tachycardia. Patient was treated with thyrozol (thiamazole) and propranolol. We need to increase awareness to adverse event of antihyperthyroid drugs, remission rate, predictor factors in successful treatment to get a better long-term outcomes of medical therapy in Grave’s disease.
    VL  - 6
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    ER  - 

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Author Information
  • Department of Child Health, Udayana University, Sanglah Hospital, Denpasar, Bali, Indonesia

  • Department of Child Health, Udayana University, Sanglah Hospital, Denpasar, Bali, Indonesia

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