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Three-year-old boy presenting in thyrotoxicosis

J E Glick¹, P E Wright

¹St Anthony Hospital, Oklahoma City, Okla., USA.

The Journal of the American Osteopathic Association

|March 24, 1998

Summary

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Graves' disease, a rare cause of thyrotoxicosis (overactive thyroid) in children, can occur in very young patients. This case highlights the importance of considering Graves' disease in any child with hyperthyroid symptoms.

Area of Science:

Pediatric Endocrinology
Autoimmune Disorders
Thyroidology

Background:

Thyrotoxicosis, characterized by accelerated metabolism, is rare in childhood.
Graves' disease accounts for the majority of pediatric thyrotoxicosis cases.
Childhood Graves' disease is more common in females and typically presents in adolescence.

Observation:

A 3-year-old Black boy presented with thyrotoxicosis secondary to Graves' disease.
This patient had no prior history of thyroid dysfunction.
Cases of Graves' disease in children under 4 years old are exceptionally rare, representing less than 2% of documented pediatric hyperthyroidism.

Findings:

The case represents a rare occurrence of Graves' disease in a pre-school-aged male child.

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The incidence of childhood Graves' disease is extremely low, with fewer than 0.000001% of cases reported.

Hospital records confirm the rarity, with only three similar cases in 17 years.

Implications:

Physicians should maintain a high index of suspicion for Graves' disease in children presenting with hyperthyroid symptoms, irrespective of age.
Early consideration of Graves' disease is crucial for timely diagnosis and management in pediatric patients.
This case underscores the need for broader age consideration in the differential diagnosis of pediatric thyrotoxicosis.