Notes for the general paediatrician: managing thyrotoxicosis in children and young people

Autor: Marianna Vidouris, Christopher Worth, Leena Patel, Anjali Date, Anas Jasser, Beverly Hird, Lesley Tetlow, Indraneel Banerjee
Rok vydání: 2022
Předmět:
Zdroj: BMJ Paediatrics Open. 6:e001582
ISSN: 2399-9772
DOI: 10.1136/bmjpo-2022-001582
Popis: Thyrotoxicosis due to hyperthyroidism is a serious disorder in childhood often presenting to general paediatricians with a range of clinical manifestations. The commonest cause is Graves’ disease, an autoimmune disorder resulting from thyrotropin receptor stimulation by autoantibodies. Early recognition and accurate interpretation of investigations are essential to achieve and maintain a euthyroid state. This will not only optimise growth, development and transition from childhood to young adult life but also avoid the potentially severe and life-threatening complications of acute thyrotoxicosis. In this review, we have focussed on the general paediatrician’s perspective of the presentation and management of thyrotoxicosis and the need to network with specialist paediatric endocrine centres to optimise patient care. We have discussed nuances of therapy, side effects and long-term outcomes, while recognising that limited remission rates in this age group often necessitate more definitive management. While carbimazole is usually used as first-line medical therapy, we have provided useful information to guide paediatricians in the discussion of individualised safe and effective treatment plans for both short-term and long-term management.
Databáze: OpenAIRE