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Case 67 - Pediatric Graves’ disease

from Section 7 - Endocrine - reproductive imaging

Published online by Cambridge University Press:  05 June 2014

By
Sami M. Akram  and
Andrei Iagaru
Edited by
Heike E. Daldrup-Link  and
Beverley Newman
Sami M. Akram
Affiliation:
Stanford University
Andrei Iagaru
Affiliation:
Stanford University
Heike E. Daldrup-Link
Affiliation:
Lucile Packard Children's Hospital, Stanford University
Beverley Newman
Affiliation:
Lucile Packard Children's Hospital, Stanford University
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Summary

Image description

A 15-year-old girl presenting with tachycardia, heat intolerance, and goiter is found to have elevated free thyroxin (FT4) and low thyroid-stimulating hormone (TSH) (FT4 = 6 ng/mL [normal: 2–4 ng/mL], serum TSH = 0.01 μIU/mL [normal: 1–5 μIU/mL]). The iodine-123 (123I) uptake and scan showed homogeneously increased radiotracer uptake. The isthmus and the pyramidal lobe were prominent. The 24 hours 123I neck uptake was 70% (normal: 10–30%) (Fig. 67.1). These features are typical of Graves’ disease.

Importance

Graves’ disease is an autoimmune disorder of multifactorial etiology and is the commonest cause of hyperthyroidism in children. The classic clinical triad of Graves’ disease includes hyperthyroidism, orbitopathy, and dermatopathy and is four to five times more frequent in girls. Peak incidence of Graves’ disease occurs in early adolescence. There is a familial predisposition; however, the hereditary component has not been clearly defined. Untreated Graves’ disease can lead to arrhythmia, heart failure, and cardiovascular collapse.

Type
Chapter
Information
Pearls and Pitfalls in Pediatric Imaging
Variants and Other Difficult Diagnoses
 , pp. 285 - 286
Publisher: Cambridge University Press
Print publication year: 2014

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References

Cho, SB, Kim, JH, Cho, S, et al. Vitiligo in children and adolescents: association with thyroid dysfunction. J Eur Acad Dermatol Venereol 2011;25(1):64–7.CrossRefGoogle ScholarPubMed
Gogakos, AI, Boboridis, K, Krassas, GE. Pediatric aspects in Graves’ orbitopathy. Pediatr Endocrinol Rev 2010;7(Suppl 2):234–44.Google ScholarPubMed
Hemminki, K, Li, X, Sundquist, J, et al. The epidemiology of Graves’ disease: evidence of a genetic and an environmental contribution. J Autoimmun 2010;34(3):J307–13.CrossRefGoogle ScholarPubMed
Horwitz, DL, Refetoff, S. Graves’ disease associated with familial deficiency of thyroxine-binding globulin. J Clin Endocrinol Metab 1977;44(2):242–7.CrossRefGoogle ScholarPubMed
Iagaru, A, McDougall, IR. Treatment of thyrotoxicosis. J Nucl Med 2007;48(3):379–89.Google ScholarPubMed
Ishizawa, T, Sugiki, H, Anzai, S, et al. Pretibial myxedema with Graves’ disease: a case report and review of Japanese literature. J Dermatol 1998;25(4):264–8.CrossRefGoogle ScholarPubMed
Prindaville, B, Rivkees, SA. Incidence of vitiligo in children with Graves’ disease and Hashimoto’s thyroiditis. Int J Pediatr Endocrinol 2011;2011(1):18.CrossRefGoogle ScholarPubMed
Zimmerman, D, Lteif, AN. Thyrotoxicosis in children. Endocrinol Metab Clin North Am 1998;27(1):109–26.CrossRefGoogle ScholarPubMed

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