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Age-Specific Concerns : Children's Health : Infants and Toddlers

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Graves’ Disease in Children

Hyperthyroidism is a disease in which the thyroid gland makes more thyroid hormone than the body needs. This hormone helps control metabolism, the speed at which the body carries out processes like heartbeats. When the body has too much thyroid hormone, the excess can cause these processes to speed up, leading to symptoms like nervousness and weight loss. The most common cause of hyperthyroidism in the U.S. is an autoimmune disorder called Graves’ disease. Children can develop Graves’ disease, although it's less common in kids than adults.

Symptoms of Graves’ disease in children

The warning signs of Graves’ disease may be different in children than in adults. Graves’ disease can be harder to spot in kids who are normally active anyway. Parents may mistake their children’s behavior for hyperactivity or even a psychiatric condition.

You may see these symptoms of Graves’ disease in children:

  • An enlarged thyroid gland (this is located in the neck, just above the collarbone)

  • Difficulty swallowing

  • Prominent or bulging eyes

  • Weight loss or poor weight gain

  • Rapid pulse

  • Hair loss

  • Irritability and mood swings

  • Lack of concentration

  • Emotional outbursts, like crying or yelling

Mothers who have Graves’ disease may pass certain antibodies to their unborn babies, causing them to develop hyperthyroidism. Symptoms in babies include:

  • Rapid heartbeat

  • Irritability

  • Swollen thyroid gland

  • Bulging eyes

  • Excessive hunger

Diagnosing Graves’ disease

Doctors can sometimes make a diagnosis of Graves’ disease based on physical symptoms, but simple tests can often confirm it. One common test for Graves’ disease is a blood test to measure the amount of thyroid-stimulating hormone (TSH) in the body.  Too little TSH may indicate hyperthyroidism.

Another blood test for Graves’ disease is the thyroid peroxidase antibodies test, which measures the amount of a certain compound in the bloodstream. High levels of this antibody can indicate Graves’ disease or another thyroid problem.

Treating Graves’ disease in children

Children who are diagnosed with Graves’ disease will usually begin taking anti-thyroid medications, such as propylthiouracil and methimazole (Tapazole), to help block the production of thyroid hormone. Symptoms will usually subside within six to eight weeks.

If your child has a serious reaction to anti-thyroid drugs or if they don’t help eliminate symptoms, radioactive iodine may be another treatment option. This oral medication destroys part or all of the thyroid gland, blocking the production of thyroid hormone.

A final treatment option is thyroidectomy, a surgical procedure to remove all or part of the thyroid. Surgery is usually done in children 5 years or older who have not responded well to anti-thyroid drugs or radioactive iodine. However, it is generally seen as a last resort.  Surgery always comes with risks, and there is a possibility that the child would need to take thyroid replacement drugs to avoid hypothyroidism, a condition in which too little thyroid hormone is produced by the body.

Outlook

People with Graves’ disease often respond well to treatment. But parents should be on the lookout for possible complications of Graves’ disease. Some people with Graves’ disease develop an eye condition known as Graves’ ophthalmopathy, which occurs when the immune system mistakenly attacks muscles and tissues around the eyes.  Some side effects from medications can also occur. If you have concerns about complications from Graves’ disease, talk with your child’s doctor.