Incidence of juvenile thyrotoxicosis in Denmark, 1982–1988. A nationwide study

Lavard, L; Ranløv, Ida; Perrild, Hans; Andersen, O. F.; Jacobsen, Bent Ascanius

doi:10.1530/eje.0.1300565

Cited by 120 publications

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“…Thyrotoxicosis is rare in children with a frequency of 0.1-3/100 000 person-years (Lavard, 1994). The majority of patients are diagnosed during puberty as was in our study where the mean age at diagnosis was 15.63  3.51 years.…”

Section: Discussionsupporting

confidence: 61%

Juvenile Hyperthyroidism

Azzoug¹,

Chentli²

2015

ijccr

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Background: Hyperthyroidism is less frequent in children than adults and its clinical profile is different.Objective: The objective of our study was to analyze the clinical characteristics of hyperthyroidism in children and adolescents. Subjects and Methods: It is a retrospective study concerning 161 patients (129 Females/32 Males) with mean age of 15.63 ± 3.51 years. Their medical records were reviewed.Results: 98.1% have Graves' disease. Appealing symptoms were thyrotoxicosis signs in 69%, ophtalmological signs in 15% and goiter in 16%. Diagnosis delay was of 20.73±20.69 months. Clinical presentation was obvious in 81% and discrete in 19%. Goiter was of type II/type III in 74% and of type I in 26%, exophtalmous was present in 69% and it was severe in 12.5%. Several complications were recorded, cardiothyreosis in 1.86%, dysglycemia in 13.04%, myopathy in 3.72% and behavioral disorders in 6.83%.Conclusion: Graves' disease is the main etiology of hyperthyroidism in children and adolescents; diagnosis is often delayed although it is clinically obvious so complications may occur. Therefore hyperthyroidism should be diagnosed and treated promptly.

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Section: Discussionsupporting

confidence: 61%

Juvenile Hyperthyroidism

Azzoug¹,

Chentli²

2015

ijccr

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“…Other studies only evaluated certain age groups (8). Most studies were based on patients referred to hospital departments (6,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18), potentially leading to referral bias (19).…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of subtypes of hyperthyroidism in Denmark: a population-based study

Carlé

Pedersen

Knudsen

et al. 2011

European Journal of Endocrinology

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178

125

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Objective: Few population-based studies have described the epidemiology of subtypes of hyperthyroidism. Design: A prospective population-based study, monitoring two well-defined Danish cohorts in Aalborg with moderate iodine deficiency (nZ311 102) and Copenhagen with only mild iodine deficiency (nZ227 632). Methods: A laboratory monitoring system identified subjects with thyroid function tests suggesting overt hyperthyroidism (low s-TSH combined with high s-thyroxine or s-triiodothyronine). For all subjects, we collected information on medical history, thyroid scintigraphy and thyroid hormone receptor antibody (TRAb) measurement. Information was used to disprove or verify primary overt hyperthyroidism and to subclassify hyperthyroidism into nosological disorders. Results: From 1997 to 2000 (2 027 208 person-years of observation), we verified 1682 new cases of overt hyperthyroidism. The overall standardized incidence rate (SIR) per 100 000 person-years was 81.6, and was higher in Aalborg compared with Copenhagen (96.7 vs 60.0, P!0.001), giving an SIR ratio (SIRR (95% confidence interval (CI))) between moderate versus mild iodine-deficient areas of 1.6 (1.4-1.8). Nosological types of hyperthyroidism (percentage/SIRR (95% CI)): multinodular toxic goitre (MNTG) 44.1%/1.9 (1.6-2.2), Graves' disease (GD) 37.6%/1.2 (0.99-1.4), solitary toxic adenoma (STA) 5.7%/2.4 (1.3-3.5), 'mixed type' hyperthyroidism (TRAb-positive, scintigraphicly multinodular) 5.4%/6.0 (3.0-12), subacute thyroiditis 2.3%/0.9 (0.4-1.4), postpartum thyroid dysfunction 2.2%/1.6 (0.8-3.0), amiodarone-associated hyperthyroidism 0.8%/7.1 (1.1-65), hyperthyroidism after thyroid radiation 0.7%/12.3 (0.8-50), lithium-associated hyperthyroidism 0.7%/0.97 (0.4-4.8) and hyperthyroidism caused by various other factors 0.7%. Lifetime risk for overt hyperthyroidism was 10.5%/6.5%/2.4% (females/all/males). Conclusion: Hyperthyroidism was common in Denmark with MNTG and GD as dominating entities. The higher incidence of hyperthyroidism in the most iodine-deficient region was caused by higher frequency of MNTG, 'mixed-type', STA and amiodarone-associated hyperthyroidism.

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“…Graves' disease is the most common cause of thyrotoxicosis, accounting for about 95% of juvenile thyrotoxicosis (1). The paediatric age group of 0-15 years comprises only 5-6% of the total number of thyrotoxic patients (2).…”

Section: Introductionmentioning

confidence: 99%

Childhood Graves’ ophthalmopathy: results of a European questionnaire study

Krassas¹,

Segni²,

Wiersinga³

2005

eur j endocrinol

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Objective: Evaluation of the frequency of Graves' ophthalmopathy (GO) and its management in children and adolescents up to 18 years old with Graves' hyperthyroidism. Study design: This was a questionnaire study (QS) among members of the European Thyroid Association and the European Society for Paediatric Endocrinology. Approximately 300 QS were sent to members with electronic addresses and 110 QS were returned from 25 countries: 52 respondents said they had no experience with Graves' disease in this age group, but 67 respondents (23 paediatric and 44 adult endocrinologists) completed the QS. Results: Out of 1963 patients with juvenile Graves' hyperthyroidism seen by respondents in the last 10 years, 641 (33%) had GO; about one-third of GO cases were # 10 years old, and two-thirds were 11-18 years old. The prevalences of GO among juvenile Graves' hyperthyroidism were 36.6, 27.3 and 25.9% in countries in which the smoking prevalence among teenagers was $ 25, 20-25 and , 20% respectively (P , 0.0001 by x 2 test). When confronted with the standard case of a 13-year-old girl with Graves' hyperthyroidism and moderately severe active GO, the diagnostic approach included on average 4.9 biochemical tests (TSH, free thyroxine (FT 4 ) and TSH.R-Ab, 100-88% of respondents) and 2.4 specific investigations (thyroid ultrasound by 69%, orthopsy/visual fields/visual acuity by 64% and orbital magnetic resonance imaging or computed tomography by 63%). Antithyroid drugs were the treatment of choice for 94% of respondents; 70% recommended a wait-and-see policy and 28% corticosteroids for the co-existing GO. In variants of the standard case, a younger age did not affect therapeutic approach very much. Recurrent hyperthyroidism would still be treated with antithyroid drugs by 66%, and with 131 I by 25%. Worsening of GO or active GO when euthyroid would convince about two-thirds of respondents to initiate treatment of GO, preferably with steroids. Conclusion: GO occurs in 33% of patients with juvenile Graves' hyperthyroidism; its prevalence is higher in countries with a higher prevalence of smoking among teenagers. The diagnostic approach to the standard case of a 13-year-old with Graves' hyperthyroidism and moderately severe active GO involves on average five biochemical tests; thyroid as well as orbital imaging is done in 84% of cases. Antithyroid drugs remain the treatment of choice for 94% of respondents, and even so in case of recurrences (66%). For GO, 70% recommend a wait-and-see policy; intervention, preferably with steroids, is advocated by two-thirds of respondents in cases of worsening or still-active eye disease despite euthyroidism.European Journal of Endocrinology 153 515-520

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Incidence of juvenile thyrotoxicosis in Denmark, 1982–1988. A nationwide study

Cited by 120 publications

References 0 publications

Juvenile Hyperthyroidism

Juvenile Hyperthyroidism

Epidemiology of subtypes of hyperthyroidism in Denmark: a population-based study

Childhood Graves’ ophthalmopathy: results of a European questionnaire study

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