AI Article Synopsis

  • Graves' disease is very rare in kids under five, and usually, doctors use medicine to treat it, but those medicines have some risks.
  • A baby boy with health issues got Graves' disease at five months old and needed surgery at nine months after his medicine stopped working.
  • This case is special because it's the youngest known child with this disease, and it hints that there might be a connection between mitochondrial problems and early thyroid issues.

Article Abstract

Objectives: Graves' disease (GD) is rare in children under age five years. Antithyroid drugs are typically first-line therapy but carry the risks of agranulocytosis and liver dysfunction.

Case Presentation: A male infant with multiple congenital anomalies, left ventricular hypertrophy, and neurologic dysfunction developed GD at five months of life. The presence of chronic hepatitis complicated medical management. Potassium iodide was effective temporarily, but urgent thyroidectomy was required at nine months of age. Postoperatively, the patient developed a thyroid function pattern consistent with impaired pituitary sensitivity to thyroid hormone (TH) that responded to the addition of liothyronine. Exome sequencing revealed a heterozygous duplication of the gene cluster, suggesting a possible mitochondrial disorder.

Conclusions: This case describes the youngest child to date to be diagnosed with endogenous GD and to successfully undergo definitive treatment with thyroidectomy. An underlying defect in mitochondrial function is suspected, suggesting a potential novel pathophysiologic link to early-onset thyroid autoimmunity. Additionally, this case illustrated the development of impaired pituitary sensitivity to TH following thyrotoxicosis of postnatal onset, which may contribute to our understanding of hypothalamic-pituitary-thyroid (HPT) axis development.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10653980PMC
http://dx.doi.org/10.1515/jpem-2020-0549DOI Listing

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