Skip to main content Skip to main navigation menu Skip to site footer

GRAVES DISEASE IN A 16 YEAR-OLD FEMALE: A CASE REPORT

Abstract

GRAVES DISEASE IN A 16 YEAR-OLD FEMALE: A CASE REPORT

Ni Wayan Yuliandari, I Made Arimbawa

Department of Child Health, Faculty of Medicine-Udayana University

Sanglah Public Hospital-Bali

 

ABSTRACT

Graves’ Disease is an autoimmune disease which is originated from production of Thyroid-Stimulating Immunoglobulins leading to overproduction of thyroid hormone. Most Graves’ disease case reported to date are associated with adults, which makes extrapolation of the result to children and adolescents particularly challenging. A 16-year-old female presented with a slowly-enlarging painless mass in her front neck over a three-year period, sensation that food is getting stuck in the upper throat, lack of concentration and attentiveness, and easily feelings fatigue. Her aunty has a history of Struma surgical treatment. Thyroid Ultrasound, thyroid function tests, Thyroid Peroxidase Antibody, and Thyroglobulin Antibody revealed Graves’ disease. She takes 5 mg of Thiamazole once daily and shows improvement after four weeks.

 

Keywords: Graves’ disease, autoimmune, family history

 

 

 

 

 

 

 

ABSTRAK

Penyakit Graves’ adalah penyakit autoimun yang disebabkan oleh produksi Thyroid-Stimulating Immunoglobulins berlebih sehingga menghasilkan kelebihan hormon tiroid. Penyakit ini umumnya terjadi pada orang dewasa dan jarang ditemukan pada remaja maupun anak-anak. Seorang remaja perempuan datang dengan pembesaran pada leher bagian depan, tidak terasa sakit, kadang merasa terganjal pada kerongkongan, mudah lelah, dan kehilangan konsentrasi sejak 3 tahun lalu. Terdapat riwayat operasi struma pada bibi pasien. Ultrasonografi tiroid, fungsi tiroid, dan pemeriksaan antibodi tiroid menyokong adanya Penyakit Graves’. Tablet Thiamazole sebanyak 5 mg diberikan sekali sehari dan terdapat perbaikan kondisi maupun laboratorium dalam waktu empat minggu.

 

Kata kunci: Graves’ disease, autoimmune, family history

 

 

References

  1. Lavard L, Ranløv I, Perrild H, Andersen O, Jacobsen BB. Incidence of juvenile thyrotoxicosis in Denmark, 1982-1988. A nationwide study. Eur J Endocrinol. 1994;130:565–8. [PubMed]
  2. Rivkees SA, Mattison DR. Propylthiouracil (PTU) hepatoxicity in children and recommendations for discontinuation of use. Int J Pediatr Endocrinol 2009. 2009 132041.
  3. Léger J, Gelwane G, Kaguelidou F, Benmerad M, Alberti C French Childhood Graves’ Disease Study Group. Positive impact of long-term antithyroid drug treatment on the outcome of children with Graves’ disease: national long-term cohort study. J Clin Endocrinol Metab. 2012;97:110-9
  4. Rivkees SA, Mattison DR. Ending propylthiouracil-induced liver failure in children. N Engl J Med. 2009;360:1574–5.
  5. Cappa M, Bizzarri C, Crea F. Autoimmune thyroid diseases in children. J Thyroid Res 2010. 2011 675703. [PMC free article] [PubMed]
  6. Slyper AH, Wyatt D, Boudreau C. Effective methimazole dose for childhood Graves’ disease and use of free triiodothyronine combined with concurrent thyroid-stimulating hormone level to identify mild hyperthyroidism and delayed pituitary recovery. J Pediatr Endocrinol Metab. 2005;18:597–602. [PubMed]
  7. Bahn RS, Burch HB, Cooper DS, Garber JR, Greenlee MC, Klein I, et al. Hyperthyroidism and other causes of thyrotoxicosis: Management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Endocr Pract. 2011;17:456–520.
  8. Chung YJ, Lee BW, Kim JY, Jung JH, Min YK, Lee MS, et al. Continued suppression of serum TSH level may be attributed to TSH receptor antibody activity as well as the severity of thyrotoxicosis and the time to recovery of thyroid hormone in treated euthyroid Graves’ patients. Thyroid. 2006;16:1251–7. [PubMed]
  9. John M, Sundrarajan R, Gomadam S. Anti-thyroid drugs in pediatric graves disease. Indian J Endocrinol Metab. 2015;19(3):340-6.
  10. Lanas A, Diza P, Eugenin D, Gonzalez F, Cid P, Cordero F, et al. Clinical features of patients with basedow graves disease seen at a university hospital. Rev Med Chil. 2017;145(4):436-440.
  11. Boiro D, Ciedhiou D, Niang B, Sow D, Mbodi M, Sarr A, et al. Hyperthyroidism in children at university hospital in Dakar(enegal). Pan Afr Med. 2017; 28(10)
  12. Yasuda K, Miyoshi Y, Tachibana M, Namba N, Miki K, Nakata Y, et al. Relationship between dose of hyperthyroid drugs and adverse events in pediatric patients with grave’s disease. Clin Pediatr Endocrinol. 2017;26(1):1-7
  13. Leger J, Carel C. Management of endocrine disease: arguments for the prolonged use of antithyroid drugs in children with graves disease. Eur J Endocr, 2017;177:R59-67
  14. Hwang SM, Kim MS, Lee DY. Predictive factors for early response to methimazole in children and adolescents with graves disease: a single-institute study between 1993 and 2013. Ann Pediatr Endocrinol Metab. 2016;21:70-4.
  15. Choi YJ, Jang JH, Park SH, Oh JH, Koh DK. Dilated cardiomyopathy with graves disease in a young child. Ann Pediatr Endocrinol Metab. 2016;21:92-5
  16. Elfenbein DM, Katz M, Schneider DF, Chen H, Sippel RS. Thyroidectomy for graves disease in children: indications and complications. J Pediatr Surg. 2016;51(10):1680-3
  17. Singh A, Purani C, Mandal A, Mehariya K, Das RR. Prevalence of thyroid disorders in children at a tertiary care hospital in western India. J Clin Diagn. 2016;10(2):SC01-4
  18. Sanyal D, Chatterjee S. Hyperthyroidism in children: treatment outcomes and preference in Eastern India. Clin Pediatr Endocriol. 2015;24(2):65-6
  19. Batubara, Jose RL. Buku Ajar Endokrinologi Anak Edisi 1. Jakarta 2010. Badan Penerbit IDAI
  20. Weetman AP. Graves Disease. New England Journal. 2000;343(17):1236-48
  21. Woeber KA. Update on the manajament of hyperthyroidism and hypothyroidism.200;160:1067-71
  22. Wu VT, Lorenzen A.W., Beck A.C., Reid V.J., Sugg S.L., Howe J.R., et al. Comparative analysis of radioactive iodine versus thyroidectomy for definitive treatment of graves disease. Surgery. 2017;161(1):147-55

How to Cite

Yuliandari, N. W., & Arimbawa, I. M. (2019). GRAVES DISEASE IN A 16 YEAR-OLD FEMALE: A CASE REPORT. Medicina, 50(1). https://doi.org/10.15562/medicina.v50i1.349

HTML
195

Total
3875

Share

Search Panel