Hyperthyroidism in Children

Clinical Description

Metabolic disorder resulting from excessive circulating thyroid hormones

Causes:

• Diffuse toxic goitre/ Graves’ disease
• Thyroiditis
• TSH induced
• TSH producing tumour
• Inappropriate secretion of TSH

Signs and Symptoms

• Weight loss, Sweating, Palpitations, Tremor, Muscle weakness and Hypertension

Investigations

• Thyroid function test
• Thyroid antibodies
• Radionuclide thyroid scan

Treatment

• The aim is to Induce remission and Improve symptoms of thyrotoxicosis.

Pharmacological

• Carbimazole 0.5-1mg/kg/day in 3 divided doses (maximum dose not to exceed 30mg/day)
• Propranolol 0.5 – 1 mg PO 2 -3 times a day
• If unresponsive consider radioactive iodine

Complications

• Thyroid crisis
• High output cardiac failure

Complications and Referral Criteria

• All patients with suspected hyperthyroidism

If a patient develops a fever or sore throat while taking Carbimazole, neutropenia should be urgently excluded. If present, then stop Carbimazole and treat with antibiotics.