Childhood Hyperthyroidism

Abstract

Thirty-nine patients with childhood hyperthyroidism were treated during the period 1950-1964, most of them after 1955. The youngest patient was 3 years old. Thyroid nodules occurred in 55 per cent of the cases. In 25 patients long-term anti-thyroid treatment was instituted. This therapy was considered as successful in 7 instances (29 per cent). Four patients (17 per cent) are still under treatment, while in 13 (54 per cent) operation was later regarded as advisable owing to unsuccessful anti-thyroid treatment. The failure of thyrostatic therapy may have had some connection with the presence or appearance of thyroid nodules. In eight instances operation was carried out, primarily owing to compressive and/or nodular goitre. The results of operation (21 cases in all) are that 10 patients are euthyroid (48%) and 4 hypothyroid (19%) whilst 7 had a relapse or persistence of the disease (33%) of whom 5 are still under treatment and two have subsequently been rendered euthyroid by reoperation in one case and radioactive iodine (at the age of 19) in another case. There also seems to be a small group of patients (6 cases in this series) in whom, in spite of evident »biochemical disease« although with slight clinical signs and symptoms, the condition seems to resolve spontaneously and nothing but close observation appears to be needed. A primarily conservative attitude seems advisable. The presence of nodules in the thyroid initially, however, seems to indicate that a surgical approach will be required later on.