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Minimal Invasive Resection of Large Retrosternal Thyroid Goiter
Published on: September 20, 2024
A 3-year-old girl with Graves' disease with literature review
Yo Han Ho1, Eun Cho Chung1, Sin-Ae Park1
1Department of Pediatrics, Presbyterian Medical Center, Jeonju, Korea.
Insights
This case report details Graves' disease in a 3-year-old, highlighting its rarity in young children. Early diagnosis and treatment are crucial for managing pediatric hyperthyroidism and preventing developmental issues.
Area of Science:
- Pediatric Endocrinology
- Autoimmune Diseases
Background:
- Graves' disease is the primary cause of hyperthyroidism in children.
- It is exceptionally rare in children under 4 years old.
- Untreated hyperthyroidism can impede growth and development.
Purpose of the Study:
- To report the first case of Graves' disease in a child under 4 years old in Korea.
- To emphasize the importance of recognizing and treating this condition in very young children.
Main Methods:
- Case presentation of a 3-year-old girl with symptoms of hyperthyroidism.
- Laboratory tests including thyroid hormones (T3, free T4, TSH), antimicrosomal antibody, and TSH-binding inhibitory immunoglobulin.
- Thyroid scan to assess gland size and function.
Main Results:
- The patient presented with goiter, exophthalmos, heat intolerance, and hyperactivity.
- Initial thyroid hormone levels were normal, but TSH was decreased.
- Elevated antimicrosomal antibody and TSH-binding inhibitory immunoglobulin levels were detected.
- Thyroid scan revealed diffuse enlargement and increased uptake.
- Hyperthyroidism developed 3 months after initial presentation.
- The patient was diagnosed with Graves' disease and treated with methimazole.
Conclusions:
- Graves' disease can occur in children younger than 4 years old.
- This case represents the first documented instance in Korea.
- Prompt diagnosis and management are essential for affected children.
Abstract:
Graves' disease, the main cause of hyperthyroidism in the pediatric age group, is very rare in children younger than 4 years old but can seriously interfere with growth and development if not recognized and treated. Here we report a case of a 3-year-old girl with Graves' disease who presented with goiter, exophthalmos, heat intolerance, and hyperactivity. At her first visit, her serum concentrations of triiodothyronine (T3) and free thyroxine (free T4) were normal, whereas that of thyroid-stimulating hormone (TSH) was decreased. Antimicrosomal antibody was 7,053.94 IU/mL, and TSH-binding inhibitory immunoglobulin was 31.62%. A thyroid scan showed diffuse enlargement with markedly increased uptake of both thyroid glands. Although T3 and free T4 levels were initially normal, she developed hyperthyroidism 3 months later. She was finally diagnosed with Graves' disease and treated with methimazole for 6 months. This is the first report of Graves' disease in children younger than 4 years old in Korea.
