Paediatrics: Hyperthyroidism (thyrotoxicosis)
Thyrotoxicosis: refers to the clinical, physiological, and biochemical findings that result when the tissues are exposed to excess thyroid hormones.
- Thyrotoxicosis: refers to the clinical, physiological, and biochemical findings that result when the tissues are exposed to excess thyroid hormones.
- Hyperthyroidism: denotes those conditions resulting in hyperfunction of the thyroid gland leading to a state of thyrotoxicosis.
Causes of thyrotoxicosis
Due to hyperthyroidism
- Excessive thyroid stimulation:
- Graves’s disease
- Hashimoto’s disease
- neonatal (transient) thyrotoxicosis
- pituitary thyroid hormone resistance (excess TSH)
- McCune–Albright syndrome
- hCG-secreting tumours
- Thyroid nodules (autonomous):
- toxic nodule/multinodular goitre
- thyroid adenoma/carcinoma
Not due to hyperthyroidism
- Exogenous thyroid hormones
Clinical features (all causes)
Thyrotoxicosis may be associated with the following symptoms:
- poor concentration; altered mood; insomnia;
- heat intolerance/fatigue/muscle weakness/wasting;
- weight loss despite increased appetite;
- altered bowel habit—diarrhoea;
- menstrual irregularity;
- sinus tachycardia; increased pulse pressure;
- hyperreflexia; fine tremor;
- Thyroid function tests (serum): raised T4 and T3; suppressed TSH.
- Thyroid antibodies: antithyroid peroxidase; anti-thyroglobulin; TSH receptor antibody (stimulatory type).
- Radionucleotide thyroid scan: increased uptake (Graves’s disease); decreased uptake (thyroiditis).