Hyperthyroidism in children manifests itself (and heals) similarly to adults, with the difference that not all symptoms can be noticed. This is especially true for the youngest children who cannot describe how they are feeling. If your child has trouble concentrating, gets tired quickly, wakes up at night, is nervous and constantly complains that he is hot, maybe he has an overactive thyroid gland.

Hyperthyroidism in children(Latinhyperthyreosisorhyperthyreoidismus ) is rare, associated mainly with mature women (ladies get it about 7 times more often than men), but it is more and more often diagnosed in the youngest.

The thyroid is an odd organ with a volume of 18 ml in women and 25 ml in men, located in the lower part of the neck, symmetrically in relation to the trachea. It consists of two lobes - in the shape of a butterfly - connected in the middle by a strait. The thyroid gland plays a very important role in the body. It produces and secretes into the blood the hormones triiodothyronine (T3) and thyroxine (T4), which are responsible for metabolism in organs and tissues of the body. They affect, for example, the functioning of the digestive system, heart, muscles, and the nervous system.

Hyperthyroidism, whether in a child or an adult, is when the amount of hormones produced by the thyroid gland significantly exceeds the body's need for them. Why does the thyroid gland produce so many hormones? The problem may be with an immune system disorder, thyroid nodules, inflammation of the thyroid gland, or taking certain medications.

Years ago, hyperthyroidism in children usually appeared as a result of treatment for hypothyroidism, as children were prescribed the same doses of drugs as adults. Today, however, that has changed and the main cause of hyperthyroidism in children is Graves' disease, an autoimmune disease in which B cells secrete an enzyme similar to the TSH hormone. Consequently, the thyroid gland produces more T3 and T4 hormones, which of course leads to unpleasant symptoms for the baby. In a child, hyperthyroidism is so dangerous that it can disturb the development of a young organism. Thyroid hormones are responsible for the formation and development of the systemnervous system, regulate essential processes of growth and maturation.

Symptoms of hyperthyroidism in children

Diseases of the thyroid gland are very rare in children, and because they give a variety of symptoms that do not have to occur simultaneously, it sometimes takes a long time to discover their cause, i.e. make a diagnosis. It is certainly easier to detect thyroid disease, including hyperthyroidism, if, for example, the mother suffers from it.

It should be noted that children (small - with teenagers, of course, the matter is easier) usually cannot describe how they feel. The older ones, on the other hand, may take certain symptoms as their characteristics - "I do" and not talk about it either. Therefore, in order to make a correct diagnosis, you will need the perceptiveness of parents and insightful questions of the doctor. Parents are not always able to notice that a child is often tired, and symptoms such as heart palpitations and chills are almost impossible to observe. So you should be alert to such statements: "mom, my heart is beating", "mom, my neck hurts". What else should get the parent's attention?

  • excessive sweating, warm, moist skin, dermographism, rashes
  • red eyes
  • bulky eyes - a symptom that should immediately prompt you to see a doctor
  • baby constantly undressing (I'm hot!)
  • hyperactivity
  • shaking hands
  • timidity
  • irritability
  • trouble concentrating
  • diarrhea, weight loss - and good appetite
  • hair loss
  • difficulty falling asleep, waking up at night
  • difficulty walking up the stairs, muscle weakness ("my legs hurt")
  • growth acceleration
  • tachycardia or accelerated heartbeat (can be felt during a long hug, e.g. while watching a movie)
  • in older girls, already menstruating, longer cycles, scanty bleeding
  • accelerated onset of the first menstruation, even before the age of 9

In very severe symptoms, hospitalization is recommended, as they may lead to a thyroid crisis, which is a life-threatening condition.

Important

Thyroid diseases can be hereditary. If a parent, usually a mother, has thyroid problems, the baby may also be sick. In this case, the child must be monitored in this respect from the very beginning. It is important to check not only the level of TSH, but also to perform an ultrasound of the thyroid gland. The baby may already be bornwith a thyroid disorder (if, for example, the pregnant mother took medication), or he may develop thyroid disease later, e.g. as a result of too little thyroid gland.the amount of iodine in the diet, the presence of other autoimmune diseases, or damage to the gland.Already in the first 24 hours of life, symptoms similar to those in older children may occur, but for newborns they can have serious consequences - tachycardia, thrombocytosis (decrease in the number of blood platelets), failure circulation. Treatment must be started as soon as possible.

Diagnostics of an overactive thyroid gland

First, you need to perform a blood test: the level of the pituitary gland hormone TSH and thyroid hormones - T3 (triiodothyronine) and T4 (thyroxine). In addition, anti-TSH receptor antibodies - TRab and anti-TPO anti-thyroid peroxidase are measured. The endocrinologist also examines the thyroid gland by palpation, because its enlargement can already be detected in this way, and performs an ultrasound of the thyroid gland. However, diagnosing an overactive thyroid is just the beginning. You need to find the cause of the increased work of the thyroid gland. Fighting the effects of overproducing thyroid hormones can be long and difficult.

Causes of an overactive thyroid gland

  • Graves' disease - an autoimmune disease; there are antibodies in the baby's blood that stimulate the thyroid gland to overproduce hormones; Graves' disease in young children is rarely diagnosed, but its incidence increases with age, most often it is diagnosed in adolescents
  • thyroid hormone resistance syndrome - characterized by both symptoms of hyperthyroidism and hypothyroidism; the disease includes diffuse parenchymal goitre, emotional disorders, hearing disorders, disturbances in the development of the skeletal system
  • neutral goiter - goiter enlarged as a consequence of iodine deficiency (in this case, the treatment may only include the administration of potassium iodide, sometimes also in combination with thyroxine, after a few months of therapy, the goiter should decrease, and if not, the diagnosis should be deepened and plan further treatment)
  • acute thyroiditis, purulent inflammation - a bacterial thyroid disease with an enlarged and painful gland, with signs of a general infection, the treatment is antibiotic therapy

Very rare:

  • thyroid nodules - usually it is a single nodule, sometimes several. Everyone should be examined to exclude a neoplastic process, the diagnosis of such a nodule is an indication for the administration of L-thyroxine, which should reduce it by half within 6 months, otherwise the nodule should be surgically removed
  • TSH-secreting pituitary adenoma
  • malignant thyroid tumors

Treatment of hyperthyroidism inchildren

There are three basic methods:

  • pharmacological - administration of antithyroid drugs, such as thiamazole, propylthiouracil, methylthiouracil. They inhibit the production of thyroid hormones; treatment is long-term (up to 2 years) and carries a high risk of side effects (liver damage, bone marrow damage). In order to slow down the heart rate, propranolol is given
  • iodination - administration of a single dose of radioactive iodine isotope (J 131), the so-called radioiodine, which is to reduce the production of hormones by the thyroid gland and the gland itself (after 8 years of age)
  • surgery - excision of a larger part of the thyroid gland or a fragment with nodules

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