ABSTRACT
Several conditions cause hyperthyroidism in childhood. This chapter focuses on Graves’ disease (GD) which is the most common cause of hyperthyroidism. Hyperthyroidism can present with overt symptoms, silently, or with isolated thyromegaly. One of the universal features of hyperthyroidism is tachycardia. GD is an autoimmune disorder caused by thyroid gland stimulation by thyroid receptor antibodies and involves genetic factors. In comparison with adults, eye disease occurs in the minority of pediatric patients with GD, and when it occurs, is usually mild. Surgery is an effective form of therapy for GD if it can be performed by an expert surgeon and in some situations is preferable to radioactive iodine. Neonatal thyrotoxicosis most commonly occurs in the setting of active or past maternal GD. Uncommonly, thyrotoxicosis is an initial thyrotoxic phase in patients with Hashimoto’s thyroiditis in which immunologic destruction of thyroid tissue results in the release of preformed thyroid hormone.
