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[Difficulties in managing Graves' disease in children: about a case]
Nassiba Elouarradi1, Ghizlane El Mghari1, Nawal El Ansari1
1Service d'Endocrinologie, Diabétologie et Maladies Métaboliques, CHU Mohamed VI, Faculté de Médecine et de Pharmacie, Université Cadi Ayyad, Marrakech, Maroc.
The Pan African Medical Journal
|November 21, 2018
Summary
Graves disease management in children remains challenging. This case highlights treatment difficulties, including side effects from antithyroid drugs and the need for alternative therapies like radioactive iodine therapy.
Area of Science:
- Pediatric Endocrinology
- Thyroidology
- Internal Medicine
Background:
- Graves' disease is the leading cause of hyperthyroidism in children, yet its optimal management, including treatment duration and alternative therapies, is debated.
- Effective management strategies for pediatric Graves' disease are crucial due to potential long-term health implications.
Observation:
- A case of an 11-year-old female presenting with symptoms of hyperthyroidism, including weight loss, diarrhea, and cervical swelling.
- Diagnosis of Graves' disease was confirmed through clinical and paraclinical evaluations.
Findings:
- Medical treatment with carbimazole was initiated, but the patient developed thrombocytopenia, necessitating cautious administration.
- After four years without remission, radioactive iodine therapy was indicated as an alternative treatment.
- Synthetic antithyroid drugs, while common, can have adverse effects, as demonstrated in this case.
Implications:
- This case underscores the complexities in managing pediatric Graves' disease, particularly concerning medication side effects and treatment resistance.
- The findings suggest that alternative therapies such as radioactive iodine therapy should be considered when medical management fails or causes significant adverse events.
- Further research into optimizing treatment duration and indications for alternative therapies in pediatric Graves' disease is warranted.