• Sara Domingues Pediatric Department, Centro Hospitalar do Tâmega e Sousa
  • Lara Isidoro Pediatric Department, Centro Hospitalar de Vila Nova de Gaia/ Espinho
  • Ana Luísa Leite Pediatric Department, Centro Hospitalar de Vila Nova de Gaia/ Espinho
  • Andreia Teles Pediatric Department, Centro Hospitalar de Vila Nova de Gaia/ Espinho
  • Jorge Sales Marques Pediatric Department, Centro Hospitalar de Vila Nova de Gaia/ Espinho
  • Rosa Arménia Campos Pediatric Department, Centro Hospitalar de Vila Nova de Gaia/ Espinho




Graves disease, hyperthyroidism, iodine, methimazole, recurrence, thyroidectomy


Introduction: Hyperthyroidism may have multiple etiologies, including Graves disease, toxic multinodular goiter and toxic adenoma. Although there is still some controversy, the first-line therapeutic option in Graves disease should be the one that best suit the characteristics of the patient and, when possible, adapted to their values and preferences.

Objective: To characterize pediatric patients with hyperthyroidism followed in a Pediatric Endocrinology Center.

Methods: Retrospective study with review of medical records of patients followed for hyperthyroidism between 2001 and 2013. Variables analyzed included demographic data, personal and family history, clinical and analytic presentation, diagnostic tests, treatment and follow-up.

Results: The study comprised 13 patients, the median age at diagnosis was 14 years and 85% were female. Regarding to etiology, 77% had Graves disease, 8% autoimmune hyperthyroidism with negative titer of thyrotropin receptor-blocking antibodies (TRAb), 8% multinodular goiter and 8% neonatal transient hyperthyroidism. In clinical presentation, we highlight the following symptoms: anxiety/irritability (46%), sudoresis (31%), palpitations (31%) and weakness/fatigue (31%) and the following signals: goiter (77%), weight loss (62%) and tachycardia (54%). 92% of patients had elevated antithyroid antibodies titers; 85% had an elevated TRAb titer. The first therapeutic option was mainly the methimazole (92%). One patient relapsed after discontinuing antithyroid medication and underwent radioiodine ablation. The patient with multinodular goiter underwent total thyroidectomy because of follicular tumor suspicion.

Conclusion: Data obtained are consistent with the literature. Therapy with methimazole presents a reduced risk of adverse reactions but low probability of remission so, in selected cases, definitive treatment should be considered.


Download data is not yet available.


Léger J, Carel JC. Hyperthyroidism in childhood: Causes, When and How to Treat. J Clin Res Pediatr Endocrinol 2013; 5:50-6.

Vilar H, Lacerda Nobre E, Jorge Z, Lopes C, André S, Salgado L, et al. Hipertiroidismo em meio hospitalar. Avaliação em cinco anos. Acta Med Port 2006; 19: 295-300.

Bahn RS, Burch HB, Cooper DS, Garber JR, Greenlee MC, Klein I, et al. Hyperthyroidism and other causes of Thyrotoxicosis: management guidelines of the American Association of Clinical Endocrinologists. Endocrine Practice 2011; 17:1-65.

Huang SA. Thyroid. In: Kappy MS, Allen DB, Geffner ME, editors. Pediatric Practice Endocrinology. 1st ed. New York: Mc Graw Hill, 2010: 107-29.

Namwongprom S, Unachak K, Dejkhamron P, Ua-apisitwong S, Ekmahachai M. Radioctive Iodine for Thyrotoxicosis in Childhood and Adolescence: Treatment and Outcomes. J Clin Res Pediatr Endocrinol 2013; 5: 95-7.

Rivkees SA, Dinauer C. Controversy in Clinical Endocrinology An Optimal Treatment for Pediatric Graves’ Disease Is Radioiodine. J Clin Endocrinol Metab 2007; 92:797–800.

Glaser NS, Styne DM. Predicting the Likelihood of Remission in Children With Graves´ Disease: A Prospective, Multicenter Study. Pediatrics 2008; 121: 481-8.

Nabhan ZM, Kreher NC, Eugster EA. Hashitoxicosis in Children: Clinical Features and Natural History. J Pediatr 2005; 146: 533-6.

Shibayama K, Ohyama Y, Yokota Y, Ohtsu S, Takubo N, Matsuura N. Assays for thyroid-stimulating antibodies and thyrotropin-binding inhibitory immunoglobulins in children with Graves´ disease. Endocrine Journal 2005; 52: 505-10.

Webster J, Taback SP, Sellers EAC, Dean HJ. Graves´ disease in children. JAMC 2003; 169:104-5.

Krassas GE, Laron Z. A questionnaire survey concerning the most favourable treatment for Graves´ disease in children and adolescents. European Journal of Endocrinology 2004; 151: 155-6.

Lewis KA, Engle W, Hainline BE, Johnson N, Corkins M, Eugster EA. Neonatal Graves’ aisease associated with severe metabolic abnormalities. Pediatrics 2011;128: 232-6.

Pinho L, Magalhães J, Pinto S, Reis MG, Cardoso H, Borges T. Bócio congénito em filho de mãe com doença de Graves: hipotiroidismo ou hipertiroidismo neonatal? Acta Pediatr Port 2010;41:176-7.



How to Cite

Domingues S, Isidoro L, Leite AL, Teles A, Marques JS, Campos RA. HYPERTHYROIDISM: EXPERIENCE OF A PEDIATRIC ENDOCRINOLOGY CENTER. REVNEC [Internet]. 2016Jun.21 [cited 2024Apr.22];25(2):64-8. Available from: https://revistas.rcaap.pt/nascercrescer/article/view/9514



Original Articles

Most read articles by the same author(s)

1 2 > >>