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Published on: September 20, 2018
Graves disease in infancy: a patient presentation and literature review
Kara Alex-Ann Beliard1, Srinidhi Shyamkumar2, Preneet Cheema Brar3
1Icahn School of Medicine, Mount Sinai Department of Pediatric Endocrinology, Kravis Children's Hospital, New York, NY, USA.
Insights
This case study details the youngest infant diagnosed with Graves disease, a form of hyperthyroidism. Early diagnosis and treatment led to a full recovery, highlighting the importance of considering this condition in infants.
Area of Science:
- Pediatrics
- Endocrinology
- Neonatology
Background:
- Hyperthyroidism, an overactive thyroid, can present in infancy with symptoms like poor weight gain and a hyperdynamic state.
- Autoimmune conditions are increasingly recognized in infants, necessitating broader diagnostic considerations.
Purpose of the Study:
- To report the youngest documented case of Graves disease in an infant.
- To emphasize the importance of early diagnosis and management of infantile hyperthyroidism.
Main Methods:
- Case report of a 12-month-old infant presenting with symptoms suggestive of hyperthyroidism.
- Biochemical confirmation of hyperthyroidism with positive thyroid-stimulating immunoglobulin.
- Treatment with methimazole and propranolol.
Main Results:
- The infant exhibited tachycardia, hypertension, diaphoresis, poor weight gain, and sleep difficulties.
- Biochemical tests confirmed hyperthyroidism.
- The patient showed a remarkable recovery following treatment with methimazole and propranolol.
Conclusions:
- Graves disease can occur in infancy and should be considered in infants with poor weight gain and hyperdynamic symptoms.
- Prompt diagnosis and treatment are crucial for managing infantile hyperthyroidism and preventing complications like craniosynostosis and growth abnormalities.
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.
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