Update on Pediatric Hyperthyroidism

Adv Pediatr. 2022 Aug;69(1):219-229. doi: 10.1016/j.yapd.2022.04.004. Epub 2022 Jun 20.


Typical symptoms which should lead to suspicion of hyperthyroidism are unintentional weight loss, tachycardia, and palpitations, heat intolerance, and hyperactivity. It is diagnosed by suppressed thyroid-stimulating hormone (TSH) with elevated thyroid hormone (TH) levels. Graves' disease (GD) due to antibodies stimulating the TSH receptor is the leading cause, and first-line treatment is with methimazole (MMI). Emerging data suggest MMI treatment, up to 8 years is effective and safe in improving the rate of remission. Radioactive iodine (RAI) and thyroidectomy offer definitive treatment and induce permanent hypothyroidism. Thyroid storm is a life-threatening condition with systemic decompensation and hyperpyrexia. Neonates of mothers with current or past GD are at risk for neonatal hyperthyroidism (NH). Appropriate identification and follow-up of at-risk neonates will reduce complications.

Keywords: Graves’ disease; Hyperthyroidism in children; Neonatal hyperthyroidism.

Publication types

  • Review

MeSH terms

  • Child
  • Graves Disease* / complications
  • Graves Disease* / diagnosis
  • Graves Disease* / therapy
  • Humans
  • Hyperthyroidism* / diagnosis
  • Hyperthyroidism* / epidemiology
  • Hyperthyroidism* / therapy
  • Infant, Newborn
  • Iodine Radioisotopes / therapeutic use
  • Methimazole / therapeutic use
  • Thyroid Neoplasms*


  • Iodine Radioisotopes
  • Methimazole