Document Detail


Management of multiple-antibody-mediated hyperthyroidism in children with Down's syndrome.
MedLine Citation:
PMID:  9076303     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
During a period of 7 years at our institution, four girls and one boy with Down's syndrome, ages 9 to 16 years, were examined and treated for hyperthyroidism. Two patients had Graves' disease and they responded to propylthiouracil (PTU) with a predictable clinical course resulting in remission within 4 years. The remaining three patients included in this report had hyperthyroid profiles similar to those of the two with Graves' disease except for their antibody panels. These patients, in addition to the elevated thyroid-stimulating immunoglobulin (TSI) level observed in Graves' disease, also had significantly elevated antimicrosomal antibody (AMA) and antithyroglobulin antibody (ATGA) at the time of diagnosis. Elevated TSI level was again present in two patients who had a recurrence of hyperthyroidism after PTU therapy was discontinued. Treatment of these three patients was best done with the continuation of PTU therapy at a lower dose and the addition of thyroxine as soon as mild hypothyroidism developed. Treatment with PTU and thyroxine was continued until the TSI level was no longer elevated. Levels of AMA and ATGA remained elevated long after the TSI level became normal. All three patients eventually had hypothyroidism and continue to require thyroxine replacement.
Authors:
S K Bhowmick; P H Grubb
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Southern medical journal     Volume:  90     ISSN:  0038-4348     ISO Abbreviation:  South. Med. J.     Publication Date:  1997 Mar 
Date Detail:
Created Date:  1997-04-17     Completed Date:  1997-04-17     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  0404522     Medline TA:  South Med J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  312-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, US Air Force Medical Center, Keesler AFB, Miss 39534-2519, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Antithyroid Agents / administration & dosage,  therapeutic use
Autoantibodies / analysis*
Child
Down Syndrome / complications*
Female
Graves Disease / complications,  drug therapy
Humans
Hyperthyroidism / complications,  drug therapy*,  immunology
Hypothyroidism / drug therapy,  etiology
Immunoglobulins, Thyroid-Stimulating / analysis*
Male
Microsomes / immunology*
Propylthiouracil / administration & dosage,  therapeutic use
Recurrence
Remission Induction
Thyroglobulin / immunology*
Thyroxine / administration & dosage,  therapeutic use
Chemical
Reg. No./Substance:
0/Antithyroid Agents; 0/Autoantibodies; 0/Immunoglobulins, Thyroid-Stimulating; 0/anti-thyroglobulin; 51-52-5/Propylthiouracil; 7488-70-2/Thyroxine; 9010-34-8/Thyroglobulin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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