Graves' disease in 2.5 years old girl - 6-years-long observation.
BACKGROUND
Pediatric Graves' disease is rare in young children, more frequent in children with other autoimmune diseases or with family history of autoimmune thyroid disease.


METHODS
The 2.5 year old girl was admitted to the hospital with tachycardia and subfebrile temperature. The girl presented symptoms of atopic dermatitis. Child's mother was diagnosed with Hashimoto disease two months after the child's diagnosis. In physical examination of the child, enlarged thyroid was found. At the admission, the laboratory tests revealed decreased TSH (0.001 uIU/ml), increased both FT3 (>30 pg/ml) and FT4 (3.43 ng/dl), but normal levels of anti-thyreoglobulin antibodies (ATG - 0.64 IU/ml) and anti-thyroid peroxidase antibodies (ATPO - 0 IU/ml); thyrotropin receptor antibodies (TRAb) were not identified. The Graves' disease was diagnosed. The girl started treatment with methimazole (2x5mg) and propranolol (due to tachycardia, 2x5mg). The thyroid function (TSH, FT4 and FT3) normalized 1 year after diagnosis and hormone levels remained within normal reference values, but she received methimazole for 18 months. At presen, the patient is 8 years old. She is not receiving any treatment and her thyroid function is correct. The girl still presents symptoms of atopy.


CONCLUSIONS
In case of symptoms of tachycardia in children, the hyperthyroidism should be taken into consideration. Numerous methods of treatment provide a therapy appropriate to the age and condition of patients. Long remission after treatment with antithyroid drugs could also be achieved in younger (prepubertal) children.
Student's Association of Science, Wroclaw Medical University.
Olimpia
O
Jonak
Student's Association of Science, Wroclaw Medical University.
Joanna
J
Połubok
Departament of Basic Medical Science, Wroclaw Medical University.
Ewa
E
Barg
D013956:Antithyroid Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006111:Graves Disease / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D008713:Methimazole / Q000627:therapeutic use*; D035583:Rare Diseases / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome
D013956:Antithyroid Agents; D008713:Methimazole
Graves’ disease; children; thyreostatics