Notes for the general paediatrician: managing thyrotoxicosis in children and young people.
Endocrinology
Journal
BMJ paediatrics open
ISSN: 2399-9772
Titre abrégé: BMJ Paediatr Open
Pays: England
ID NLM: 101715309
Informations de publication
Date de publication:
11 2022
11 2022
Historique:
received:
20
06
2022
accepted:
15
08
2022
entrez:
16
1
2023
pubmed:
17
1
2023
medline:
19
1
2023
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 36645751
pii: 10.1136/bmjpo-2022-001582
doi: 10.1136/bmjpo-2022-001582
pmc: PMC9685199
pii:
doi:
Substances chimiques
Antithyroid Agents
0
Carbimazole
8KQ660G60G
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Eur Thyroid J. 2018 Aug;7(4):167-186
pubmed: 30283735
Endocr Rev. 2018 Oct 1;39(5):830-850
pubmed: 29982406
Postgrad Med J. 1996 Aug;72(850):489-91
pubmed: 8796215
Front Med (Lausanne). 2022 Feb 11;9:788228
pubmed: 35223896
Endocr Connect. 2021 Oct 25;10(11):R279-R292
pubmed: 34596580
QJM. 2001 Sep;94(9):471-3
pubmed: 11528010
Endocr Connect. 2021 Sep 28;10(10):1234-1242
pubmed: 34468398
J Pediatr. 2006 Oct;149(4):532-6
pubmed: 17011327
Clin Pediatr Endocrinol. 2017 Jan;26(1):1-7
pubmed: 28203042
Eur J Pediatr. 1999 Oct;158(10):776-9
pubmed: 10486073
Arch Dis Child. 2022 Jul 13;:
pubmed: 35831126
Arch Dis Child. 2018 Jul;103(7):637-642
pubmed: 29269558
J Biomed Phys Eng. 2017 Mar 01;7(1):21-26
pubmed: 28451576
Clin Chem Lab Med. 2022 Mar 18;60(6):808-820
pubmed: 35304841
Can J Cardiol. 2009 Jul;25(7):421-4
pubmed: 19584973
Eur J Endocrinol. 2019 Apr 1;:
pubmed: 31042675
J Clin Res Pediatr Endocrinol. 2013;5 Suppl 1:50-6
pubmed: 23154161
J Intensive Care Med. 2015 Mar;30(3):131-40
pubmed: 23920160
J Clin Endocrinol Metab. 2008 Oct;93(10):3817-26
pubmed: 18628515
Eur J Endocrinol. 2020 Dec;183(6):637-645
pubmed: 33107439
Clin Endocrinol (Oxf). 2010 Mar;72(3):358-63
pubmed: 19769613
Ann Clin Biochem. 2019 Jul;56(4):424-430
pubmed: 31023057
Eur Thyroid J. 2022 Jan 01;11(1):
pubmed: 34981748
J Endocrinol Invest. 2018 Jan;41(1):99-109
pubmed: 28853052
J Endocr Soc. 2017 Aug 08;1(9):1203-1212
pubmed: 29264576
JAMA Intern Med. 2019 Aug 01;179(8):1034-1042
pubmed: 31260066
J Clin Endocrinol Metab. 2004 Sep;89(9):4229-33
pubmed: 15356012
Eur J Endocrinol. 2021 Aug 27;185(4):G43-G67
pubmed: 34297684
Best Pract Res Clin Endocrinol Metab. 2018 Aug;32(4):373-386
pubmed: 30086864
Endocrinol Metab Clin North Am. 1993 Jun;22(2):263-77
pubmed: 8325286
Eur J Endocrinol. 2020 Jun;182(6):533-538
pubmed: 32213658
J Clin Endocrinol Metab. 2020 Jun 1;105(6):
pubmed: 32185376
J Clin Endocrinol Metab. 2003 Jul;88(7):2983-92
pubmed: 12843130
Ann ICRP. 2015 Jul;44(2 Suppl):7-321
pubmed: 26069086
Pediatr Surg Int. 2012 Jun;28(6):609-14
pubmed: 22543510
Expert Rev Clin Pharmacol. 2015;8(6):741-50
pubmed: 26437373
Arch Dis Child. 2004 Aug;89(8):745-50
pubmed: 15269076
Eur J Endocrinol. 1994 Jun;130(6):565-8
pubmed: 8205255
Ann Clin Biochem. 2011 May;48(Pt 3):276-81
pubmed: 21441394
J Pediatr Endocrinol Metab. 2013;26(11-12):1171-4
pubmed: 23740677
Eur J Endocrinol. 2020 Oct;183(4):381-387
pubmed: 32698147
Clin Chem Lab Med. 2020 Nov 26;58(12):2037-2045
pubmed: 32324155
Clin Chem. 1998 Mar;44(3):440-54
pubmed: 9510847
Clin Endocrinol Metab. 1978 Mar;7(1):47-65
pubmed: 348356
J Endocrinol Invest. 2020 Feb;43(2):123-137
pubmed: 31538314