hyperthyroidism
HYPERTHYROIDISM
Hyperthyroidism is the overactivity of the thyroid gland resulting in excessive production of thyroid hormones.
Symptoms are of gradual onset.
Earliest signs may be emotional lability and motor hyperactivity; decline in school performance may also be noted.
Causes are autoimmune (Grave's disease), inappropriate stimulation by trophic factors, passive release of preformed thyroid hormone stores in response to infections, trauma, or other offensive factors inside the body, and extra-thyroidal sources.

Follow Up

  • Thyroid function monitoring (free T4, total T3, TSH) is advised for the following:
    • Two to 6 weeks after initiation of antithyroid drug therapy, again at 4-6 weeks, then every 2-3 months once dose has been stabilized
    • Lifelong monitoring for all patients previously prescribed with antithyroid drug therapy
    • Monthly monitoring after completion of radioactive iodine therapy
  • Doses of antithyroid medications should be discontinued or titrated after 1-2 years of continuous treatment, to assess for disease remission
  • Lifelong monitoring of thyroid function is advised for all patients previously prescribed w/ antithyroid drug therapy
  • Instruct the parents/guardians of patients to immediately report signs of liver dysfunction (jaundice, pruritus, rash, anorexia, right upper quadrant pain, light-colored stool, dark urine)
  • Consider radioactive iodine therapy or surgery in patients on antithyroid therapy (Methimazole) for >1-2 years
  • Relapse after discontinuation of therapy occurs in 3-47% of pediatric population
    • Studies show that relapse usually occurs within 1 year after treatment discontinuation
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