Graves disease (GD) is the primary cause of hyperthyroidism in children. The standard management options—namely, antithyroid drugs (ATD), radioactive iodine, and surgery—have not changed for many years. Although ATD therapy is often the first-line treatment for pediatric patients, the low likelihood of spontaneous remission means that most children will require a more permanent solution. Recent clinical trials and systematic reviews have shed light on the long-term outcomes of ATD therapy, radioactive iodine, and surgical interventions in managing pediatric GD. Additionally, novel therapies aimed at B-cells or the thyroid-stimulating hormone receptor, both implicated in the pathogenesis of GD, are under investigation. However, their definitive role in treating childhood GD has yet to be established. This review will cover the latest developments in the treatment of childhood GD, including information on emerging targeted therapies.
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, Tae Jeoung Kang, Young Joo Kim, Jung Ja Ahn, Bock Hee Woo A case report is presented on a patient with Wernicke's encephalopathy secondary to hyperemesis gravidarum. The 30-year-old woman was admitted with a severe dehydrated state, ataxia, dizziness at 17 weeks. Neurologic examination demonstrated nystagmus, gait ataxia, paresthesia. The MR imaging revealed the high signal intensity in both hypothalamus, thalamus, midbrain. The neulolgic signs and MRI findings pointed to diagnosis of Wernicke's encephalopathy. The patient was complicated with hyperthyroidism. The patient was treated with parenteral thiamine and prophylthyiouracil. The pregnancy was terminated by spontaneous abortion at gestationl 18 weeks. A review of the literature published during the last 30 years revealed an additional 25 cases.
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