title: Developmental delay and failure to thrive in a 7-month-old baby boy with spontaneous transient Graves' thyrotoxicosis: a case report.
abstract: BACKGROUND
  Thyroid dysfunction can induce developmental delay and failure to thrive in infancy. Congenital hypothyroidism is one of the common causes of these symptoms in infancy. By contrast, hyperthyroidism is a rare cause of these symptoms in infancy.
  
  
  METHODS
  A 7-month-old Japanese baby boy was examined for developmental delay and failure to thrive. Blood tests were performed, which showed low levels of thyroid-stimulating hormone (<0.01 μU/mL) and high levels of free thyroxine (2.14 pg/mL). He was referred to our hospital at 8 months of age. His height was 64 cm (-2.7 standard deviation) and his weight was 6085 g (-2.5 standard deviation). No goiter was detected on examination. His thyrotropin receptor antibody was slightly high (3.9 IU/L), whereas thyroid stimulating antibody, anti-thyroglobulin antibody, and thyroid peroxidase antibody were within normal range. These blood findings indicated hyperthyroidism, most likely Graves' disease. His free thyroxine level decreased in the first month after our examination. No increased vascularity of his thyroid gland was noted. The technetium uptake of his thyroid gland in scintigraphy was relatively increased compared to the intake of his salivary gland. We elected to observe rather than treat with anti-thyroid medications.
  
  
  CONCLUSIONS
  We have to rule out spontaneous transient Graves' thyrotoxicosis when babies have symptoms of developmental delay and fail to thrive.
authors: Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan. yatsuga_shyuuichi@kurume-u.ac.jp.
authors: Shuichi
authors: S
authors: Yatsuga
authors: Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan.
authors: Tomoko
authors: T
authors: Saikusa
authors: Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan.
authors: Takako
authors: T
authors: Sasaki
authors: Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan.
authors: Kikumi
authors: K
authors: Ushijima
authors: Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan.
authors: Miyuki
authors: M
authors: Kitamura
authors: Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan.
authors: Junko
authors: J
authors: Nishioka
authors: Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan.
authors: Yasutoshi
authors: Y
authors: Koga
mesh_terms: D044466:Asian People; D002658:Developmental Disabilities / Q000097:blood; D005183:Failure to Thrive / Q000097:blood / Q000209:etiology*; D006111:Graves Disease / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D018828:Immunoglobulins, Thyroid-Stimulating / Q000097:blood; D007223:Infant; D008297:Male; D011877:Radionuclide Imaging; D012075:Remission, Spontaneous; D013960:Thyroid Function Tests; D013971:Thyrotoxicosis / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D057832:Watchful Waiting
chemical_list: D018828:Immunoglobulins, Thyroid-Stimulating
keywords: Developmental delay; Failure to thrive; Spontaneous transient Graves’ thyrotoxicosis