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Thyroid storm in pediatrics: a systematic review.

Daniela Aguilar Abisad¹, Eva Maria Glenn Lecea¹, Andrea Montano Ballesteros¹

¹Pediatrics, Nicklaus Children's Hospital, Miami, FL, USA.

Journal of Pediatric Endocrinology & Metabolism : JPEM

|November 1, 2022

Summary

Thyroid storm (TS) in children is a severe endocrine emergency with varied symptoms like fever and tachycardia. Early recognition and standardized care are crucial for better outcomes in pediatric hyperthyroidism.

Keywords:

diarrhea hyperthermia hyperthyroidism methimazole pediatrics propylthiuracil tachycardia thyroid storm

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Area of Science:

Pediatric Endocrinology
Critical Care Medicine
Systematic Review

Background:

Thyroid storm (TS) is a rare but life-threatening hyperthyroid complication, with limited pediatric data.
Existing pediatric knowledge is primarily extrapolated from adult studies.
This review addresses the need for pediatric-specific TS information.

Approach:

Systematic review of case reports and series (2000-2022) for pediatric TS (0-21 years).
Searched PubMed, Google Scholar, and LILACS using "thyroid storm" and "pediatrics".
Analyzed epidemiology, etiology, clinical presentation, and management of pediatric TS.

Key Points:

Data from 45 pediatric patients (mean age 11.25 years) were analyzed.
Common features: sinus tachycardia (86.7%), fever (64%), altered mental status (46%).
Graves' disease was the most common cause; infection the most frequent trigger.

Conclusions:

Pediatric TS presents heterogeneously with multisystemic involvement.
Standardization of diagnosis and management requires further research.
Qualitative studies are needed to explore diagnostic delays and prognostic impact.