HYPERTHYROIDISM IN CHILDHOOD AND ADOLESCENCE - CLINICAL SYMPTOMS, THERAPY AND FOLLOW-UP OF 16 PATIENTS

the therapy in patients with hyperthyroidism of the pediatric age grou p. To examine if Graves Disease could be distinguished from hyperthyro id forms of the Autoimmune Thyreoiditis. Methods:The retrospective stu dy included 16 patients aged 3 to 17 years (median age 12.3 years) bet ween 1988 and 1997. We investigated clinical, laboratory and sinograph ical data. All patients were treated with antithyroid drugs. Results: Mean age at diagnosis was 11,0+/-3,6 years. 13 patients were girls. 6 of 16 patients were pubertal at the beginning of hyperthyroidism. Clin ical symptoms at presentation were nervousness (63%) and weight loss ( 56%). Symptoms had been present for a period between 10 days to 2 year s. Ophthalmopathy and pretibial myxedema were evident in 10 patients. 12 patients had positive TSH receptor antibodies. In 4 cases only anti microsomal antibodies were positive. Antithyroglobulin antibodies were positive in 10 of 13 patients. Ultrasound of the thyroid gland showed inhomogeneous, asymmetric structure in 13 patients, and thyroid volum e was above the normal range in 13 cases. 7 of 16 patients relapsed ei ther after the dosage was reduced (n=4) or after the therapy had been stopped (n=3). There was no case of a transient hyperthyroidism. One g irl was treated surgically. One boy received radiotherapy. Conclusion: long-term treatment with antithyroid drugs is well tolerated. Differe ntiation between Graves Disease and Autoimmune Thyroiditis was not pos sible in most of OUT cases and seems to have no consequence concerning the therapy and the prognosis.