A. A. Asban1, S. Chung1, J. Hur1, B. Lindeman1, C. Balentine1, H. Chen1 1University Of Alabama at Birmingham,Birmingham, Alabama, USA
Introduction:
Graves’ disease is the most common cause of hyperthyroidism in children (84%) and adults (80%), and can present symptoms that could impair development or have substantial long-term implications for quality of life in children. While surgery can offer definitive treatment, anti-thyroid medications and radioactive iodine (RAI) remain the most common therapeutic approaches despite potential side effects and known failure rates. We aimed to determine whether adults and children have different presenting symptoms that may impact therapeutic decisions.
Methods:
We retrospectively reviewed electronic medical records of patients with hyperthyroidism referred for thyroidectomy by one surgeon between January 2016 and April 2017. We divided our cohort into two groups: children (age ≤ 18 years), and adults (age > 18). We compared symptoms between the groups using chi-square for dichotomous variables and Kruskal-Wallis for continuous variables.
Results:
Thirty-eight patients (27 adults & 11 children) were evaluated for hyperthyroidism. Of those, 37 patients (97%) underwent total thyroidectomy and 1 (3%) underwent lobectomy. The mean age of the adult group was 44.3 years and 13.8 years for children. Twenty-nine (76%) were female with no difference in gender among groups. Children with hyperthyroidism were more likely than adults to present with hoarseness (55% vs 15%, p=0.01) and difficulty concentrating (45% vs 7%, p=0.01) (Table 1).
There were no statistically significant differences in the rates of adults and children reporting any other symptoms. A majority of patients in both groups reported palpitations, fatigue, and difficulty swallowing.
Conclusion:
Children with hyperthyroidism were more likely to present with hoarseness and difficulty concentrating than adults. Concentration and communication are critical skills in developing children, and early intervention with definitive therapy may improve such symptoms.
