The patients with hypertyroidia diagnosis retrospective evaluation

The aim of this study is to evaluate the prognosis of hyperthyroidism in children and adolescents and to evaluate the clinical course and treatment results of Graves' disease which is the main cause of hyperthyroidism in these age groups. The study population consisted of 36 patients diagnosed with hyperthyroidism between the years 2011-2018 in Uludağ University Pediatric Endocrinology Department. The diagnosis of hyperthyroidism was based on elevated free T3 and / or free T4 levels and suppressed TSH in the presence of clinical signs of hyperthyroidism. The diagnosis of Graves' disease was based on the presence of clinical and laboratory findings of hyperthyroidism and the positivity of TSH receptor antibody or presence of ophthalmopathy. The diagnosis of Hashimoto thyroiditis was made with the clinical symptoms and signs of hyperthyroidism, negative TSH receptor antibody, and increased thyroid autoantibodies and/or goiter with increased thyroid echogenicity in ultrasonography. Recurrence of symptoms and signs of hyperthyroidism after at least 18 months of antithyroid drug treatment was defined as relapse. The patients' symptoms, findings, thyroid hormones and thyroid autoantibody levels, family history, treatment regimens, side effects and treatment results were recorded as clinical and laboratory data. Regarding the etiology, Graves disease was diagnosed in 24 patients, Hashimoto's thyroiditis in 9 patients, congenital hyperthyroidism in 1 patient and toxinodular goitre in 2 patients. Medical records of 24 patients (21 girls and 3 boys) with Graves' disease were evaluated. The mean age at presentation was 11,8±6,1 years. 78.2% of the patients were pubertal at admission. Graves disease was more frequent in girls than in boys. The girls / boys ratio was 1/7. Five patients with Graves' disease (20,8%) had a family history of hyperthyroidism. Antithyroid drug therapy was started in all patients diagnosed with Graves' disease. All patients were treated with antithyroid drugs and remission was achieved in only 6 of them after a mean treatment period of 30,7 ± 17,2 months. Treatment was discontinued in 17 Graves patients; 13 of them (76%) had relapse. Antithyroid drug side effects were observed in 3 patients with Graves disease (13%); the increase in transaminases was seen in 8,6 % of patients and arthritis / arthralgia in 4,3%. Antithyroid drugs are considered as the first treatment option in patients younger than 10 years, but transaminase levels should be closely monitored in this age group. SDS of body mass index was lower in prepubertal patients with Graves' disease than in pubertal patients, but it was not significant (p = 0,035). There was no significant difference between Graves' disease and Hashimoto thyroiditis between free T3, free T4 and TSH levels (p: 0,73, 0,6, 0,31). Graves' disease should be considered in patients with severe hyperthyroidism and who require long-term antithyroid medication. Key words: Graves' disease, hyperthyroidism.