HYPERTHYROIDISM IN CHILDREN - AN INDIAN EXPERIENCE

During the period 1986-1993, 24 children with hyperthyroidism were ref erred to us for management, Two of them]had factitious hyperthyroidism , one toxic nodular goiter and another neonatal Graves' disease, Twent y children (6M, 14F) had Graves' disease, Their age at presentation wa s 10.86 +/- 2.02 years and duration of symptoms ranged from 2.5 months to 7 years, Neuropsychiatric manifestations, such as hyperkinesis, ir ritability, excitability and behavioral problems, were the most common initial presenting symptoms (90%), Goiter of varying grades was prese nt in 18 children, Eye involvement of mild or moderate intensity was p resent in 85% and cardiac involvement in 30%, Serum free thyroxine and triiodothyronine levels were high and radioactive iodine uptake was e levated, All of them received carbimazole 0.5-0.7 mg/kg in three divid ed doses, Seventeen responded to therapy over a period of time while t hree did not, On withdrawal, six of the responders relapsed, Hyperthyr oidism in children is rare and when it occurs it is almost always due to Graves' disease, The prominence of neuropsychiatric symptoms, insid ious onset and absence of severe infiltrative ophthalmopathy different iates it from the adult type of disease, Prolonged medical therapy is needed to induce good continued remission.