Hyperthyroidism - Symptoms and Signs
Symptoms and signs of hyperthyroidism.
Hyperthyroidism is an excess production of thyroid hormones. The diagnosis is made on the basis of a study of the function of the thyroid gland. Treatment is carried out with propylthio-uracil or methimazole.
Hyperthyroidism during the first years of life. Hyperthyroidism is rare in young children, but it is a potential threat to life. It develops in the fetus if a woman has a Graves' disease during pregnancy or history, increased titer of tyrostimulating immune globulins, which excessively stimulate the production of thyroid hormones by binding to thyroid stimulating hormone receptors in the thyroid gland. These antibodies cross the placenta and cause hyperfunction of the thyroid gland in the fetus, which can lead to fetal death or premature birth. Since after birth the antibody titer in a child decreases, neonatal Graves disease is usually transient in nature.At the same time, since the time of excretion of antibodies varies, the duration of neonatal Graves disease may also vary.
Symptoms and signs include anxiety, feeding difficulties, hypertension, tachycardia, exophthalmos, goitre, pronounced frontal tubercles and microcephaly. Other early signs include hypotrophy, vomiting and diarrhea. Almost always, the duration of the disease is not more than 6 months; longer duration is rare. Prolonged hyperthyroidism can lead to craniosynostosis, impaired intellect, delayed physical development, low growth and hyperactivity at an older age. Mortality can reach 10-15%.
This diagnosis should be considered if the child was born from a mother with Graves' disease and high titres of stimulating antibodies. Confirm the diagnosis by measuring serum free thyroxine and TSH. Thyrostatic drugs are prescribed to the child, sometimes in combination with symptomatic treatment with p-blockers. Treatment should be regularly monitored at short intervals and stopped as soon as the course of the disease ends.
Hyperthyroidism in older children and adolescents.Often the cause is Graves disease; it is characterized by diffuse goiter, thyrotoxicosis and rarely infiltrative ophthalmopathy. The diagnosis and treatment are similar to those in adults.
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