Childhood hyperthyroidism

Childhood hyperthyroidism is usually managed with either PTU or methimazole. Long-term follow-up smdies suggest that this form of therapy is quite acceptable, with 25% of a cohort experiencing remission every 2 years. ... 

Biebermann, H., Schoneberg, T., Krude, H., Gudermann, T, and Gruters, A. (2000) Constitutively activating TSH-receptor mutations as a molecular cause of non-autoimmune hyperthyroidism in childhood. Arch. Surg. 385, 390-392. 

Hypothyrodism and hyperthyroidism can both be due to a number of causes, one of which is metabolic dysfunction. Hypothyroidism is caused by undersecretion, of thyroid hormones. In one form of childhood hypothyroidism, children born with abnormally small thyroids produce insufficient levels of the thyroid hormones T3 and T4, which are important for metabolically directed bone development. If detected in the first 6 months of life, this disorder can be treated with synthetic thyroid hormones such that its effects can be avoided. The most severe early onset hypothyroidisms are characterized by Cretinism, a type of dwarfism, and mental retardation. Adult hypothyroidism is called myxedema. Myxedema symptoms include slowed speech, yellowed skin, and generally slowed body functions. Myxedema can also be treated with synthetic T4, but if left untreated, can lead to coma. 

Constitutively activating TSH-receptor mutations as a molecular cause of non-autoimmune hyperthyroidism in childhood. Arch Surg 385 390-392... 

D) antibodies attack the acetylcholine receptors in postS5maptic membranes. In Graves disease aberrant antibodies are directed against receptors for thyrotropin. They have a stimulatory rather than an inhibitory effect and cause hyperthyroidism. Childhood onset (lype I) diabetes results from destruction of insulin-secreting cells by an autoimmune reaction triggered by environmental factors in genetically susceptible persons (Box The... 

Hyperthyroidism occurs much less commonly in children than hypothyroidism, but it is a far more virulent condition (Takashima et al., 1995 Wilkins, 1965). In children, the most common cause of childhood thyrotoxicosis is Graves disease, which is characterized by diffuse goiter, hyperthyroidism, and occasionally ophthalmopathy (Rivkees et aL, 1998 Fisher, 1994 Zimmerman and Lteif, 1998 LeFranchi andMandel, 1995). Untreated, hyperthyroidism is associated with excessive activity, tremor, tachycardia, flushing, palpitations, accelerated linear growth, weight loss, impaired skeletal mineralization and poor performance at school (Rivkees et al., 1998 Fisher, 1994 Zimmerman and Lteif, 1998 LeFranchi and Mandel, 1995). 

---