RT Book, Section
A1 Smith, Mindy A.
A2 Usatine, Richard P.
A2 Sabella, Camille
A2 Smith, Mindy Ann
A2 Mayeaux, E.J.
A2 Chumley, Heidi S.
A2 Appachi, Elumalai
SR Print(0)
ID 1114879233
T1 Hyperthyroidism
T2 The Color Atlas of Pediatrics
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-176701-9
LK accesspediatrics.mhmedical.com/content.aspx?aid=1114879233
RD 2024/04/16
AB A  12-year-old  girl  presents  with  fatigue,  palpitations,  and  inability  to  sleep.  She  has  been  an  excellent  student  in  school  but  has  had  increasing  difficulty  concentrating  in  class  and  difficulty  focusing  her  eyes.  Family  history  was  significant  for  thyroid  disease  in  her  mother  (hypothyroid)  and  maternal  aunt  (Graves’  disease  [GD]).  On  examination,  her  pulse  is  105  beats  per  minute,  blood  pressure  112/60  mm  Hg,  and  she  is  mildly  underweight  with  a  BMI  of  15.  She  has  a  mild  resting  tremor,  proptosis  (R  >L),  and  her  thyroid  exam  reveals  a  slightly  enlarged  but  symmetric  gland  (Figure  192-1).  You  obtain  blood  work  that  reveals  a  low  thyroid-stimulating  hormone  (TSH)  and  an  elevated  free  thyroxin  level  (T4).  A  thyroid  scan  and  uptake  shows  a  diffusely  increased  intake  of  54  percent  with  no  nodules  (Figure  192-2).  The  patient  was  diagnosed  with  GD  and  the  therapeutic  options  are  presented  to  the  family.