Graves disease in infancy: a patient presentation and literature review

Abstract

Summary We describe a case of an infant who presented with clinical features of hyperthyroidism. The child was found to be tachycardic, hypertensive and diaphoretic, she was noted to have poor weight gain and difficulty in sleeping. The child was admitted to the pediatric intensive care unit for care. She was found to have biochemical evidence of hyperthyroidism with positive thyroid stimulating immunoglobulin. She responded well to methimazole and propranolol and had a remarkable recovery. She is the youngest patient to be diagnosed with Graves disease in the English literature, at 12 months of life. Learning points Hyperthyroidism must always be considered even at very young age, for patient presenting with poor weight gain and hyperdynamic state. Autoimmune diseases are becoming more common in infancy. Craniosynostosis and increased height for age are well-documented consequences of untreated hyperthyroidism in developing children.

Longitudinal follow-up of pediatric Graves’ disease in preschool children: Clinical characteristics and a case report

“…[ 1 , 7 ] The Youngest patient diagnosed with GD in the British literature is at 12 months of age. [ 8 ] GD is rare in children under 7 years of age. Children with this disease exhibit greater thyrotoxicity at diagnosis and require a longer course of medical therapy than children and adults during and after adolescence.…”

Atualizações sobre a doença de Graves neonatal: Principais avaliações diagnósticas e tratamentos

“…Subekti e Pramono (2018) eBeliard et al (2021) o diagnóstico da doença de Graves neonatal também deve ser baseado, além das manifestações clínicas, em exames laboratoriais. Os exames laboratoriais incluem a dosagem dos hormônios tireoidianos [T3 (triiodotironina) e o T4 (tiroxina)] e dos níveis do hormônio estimulante da tireoide (TSH), bem como a presença de anticorpos antirreceptores do TSH (TRAb).…”

“…e 15 de nascimento), tendo como base os em exames laboratoriais que acabaram por sinalizar a doença, mesmo após ausência de sintomas clínico.Em um caso apresentado porBeliard et al (2021) descobriu-se, através de um exame bioquímico específico no sangue, que a criança estudada apresentava TSH indetectável e T4 livre elevado, associados abaixo ganho de peso e inquietação, juntamente com moderados níveis de anticorpos anti -TPO e TRAB acentuadamente elevados. A partir de todos esses dados, juntamente com outras técnicas que auxiliaram o exame clínico, a doença foi detectada Luz et al (2020).…”