Hyperthyroidism as Graves’ disease, is most common in girls age 10-15 with an autoimmune disorder familial history. Graves disease most commonly presents with a goiter, as well as warm moist skin, restlessness, proximal muscle weakness, fine hand tremor with arm extension, growth acceleration and bone age, and potentially delayed puberty. Approximately one-third of children with hyperthyroidism develop Graves ophthalmology, yet most cases present as mild.
Diagnosis for pediatric hyperthyroidism typically begins with the screening of T3 and T4 levels, thyroid or thyrotropin receptor antibodies, and thyrotropin. T3 and T4 levels will be elevated in Graves disease, but physicians should note the level elevation may not positively correlate with symptom severity. Treatment of Graves disease typically begins with anti-thyroid drug therapy, such as methimazole. Propylthiouracil is not recommended because of liver toxicity. In severe cases, a cardioselective beta-blocker can be used temporarily. Because only an estimated 35% of children and adolescents achieve remission on drug-only treatment, definitive therapy can be considered in the form of a thyroidectomy or radioiodine ablation.