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Case 67 - Pediatric Graves’ disease

from Section 7 - Endocrine - reproductive imaging

Published online by Cambridge University Press:  05 June 2014

By
Sami M. Akram  and
Andrei Iagaru
Edited by
Heike E. Daldrup-Link  and
Beverley Newman
Sami M. Akram
Affiliation:
Stanford University
Andrei Iagaru
Affiliation:
Stanford University
Heike E. Daldrup-Link
Affiliation:
Lucile Packard Children's Hospital, Stanford University
Beverley Newman
Affiliation:
Lucile Packard Children's Hospital, Stanford University
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Summary

Image description

A 15-year-old girl presenting with tachycardia, heat intolerance, and goiter is found to have elevated free thyroxin (FT4) and low thyroid-stimulating hormone (TSH) (FT4 = 6 ng/mL [normal: 2–4 ng/mL], serum TSH = 0.01 μIU/mL [normal: 1–5 μIU/mL]). The iodine-123 (123I) uptake and scan showed homogeneously increased radiotracer uptake. The isthmus and the pyramidal lobe were prominent. The 24 hours 123I neck uptake was 70% (normal: 10–30%) (Fig. 67.1). These features are typical of Graves’ disease.

Importance

Graves’ disease is an autoimmune disorder of multifactorial etiology and is the commonest cause of hyperthyroidism in children. The classic clinical triad of Graves’ disease includes hyperthyroidism, orbitopathy, and dermatopathy and is four to five times more frequent in girls. Peak incidence of Graves’ disease occurs in early adolescence. There is a familial predisposition; however, the hereditary component has not been clearly defined. Untreated Graves’ disease can lead to arrhythmia, heart failure, and cardiovascular collapse.

Type
Chapter
Information
Pearls and Pitfalls in Pediatric Imaging
Variants and Other Difficult Diagnoses
 , pp. 285 - 286
Publisher: Cambridge University Press
Print publication year: 2014

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References

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