Zusammenfassung der Ressource
Hyperthyroidism
- usually results from Grave's disease (autoimmune thyroiditis)
- secondary to production of
thyroid stimulating Ig (TSIs)
- most often seen in teenage girls
- clinical features
- similar to adults
- but eye signs uncommon in kids
- systemic
- anxiety, restlessness
- increased appetite
- sweating
- diarrhoea
- weight loss
- rapid growth in height
- advanced bone maturity
- tremor
- tachycardia,
wide pulse Pa
- warm, vasodilated peripheries
- goitre
(bruit)
- learning difficulties/behavioural probs
- psychosis
- eye signs
- exophthalmos
- ophthalmoplegia
- lid retraction
- lid lag
- Ix
- thyroxine (T4) &/or tri-iodothyronine (T3) levels elevated
- TSH levels suppressed to very low
- Antithyroid peroxismal
antibodies may also be
present
- can -> spontaneous resolution of thyrotoxicosis
- but subseq cause hypothyroidism (called hashitoxicosis)
- Mx
- medical
Rx
- 1st line
- drugs interfering w/ thyroid hormone synthesis
- carbimazole
- thyrouracil
- risk of neutropenia
- advise fam to seek urgent help & blood count
- if sore throat and high fever
occur on starting Rx
- given for 2 years
- control thyrotoxicosis
- eye signs
may not
resolve
- 75% relapse when meds stopped
- 2nd course of meds
or surgery (subtotal
thyroidectomy)
- -> permanent remission
- beta blockers
- symptomatic relief of
- tremor
- anxiety
- bradycardia
- initially
- radioiodine
- always follow up
- thryoxine replacement often needed for subseq hypothyroidism
- neonatal hyperthyroidism
- occurs in infants of mums w/ Grave's
- from transplancental transfer of TSIs
- Rx required
- potentially fatal
- but it resolves spontaneously with time