Incidence, Clinical Presentation, and Outcome of Hyperthyroidism in Children and Adolescents: A Single-Centre Study
https://doi.org/10.15605/jafes.041.S1
- Author:
Sivaneshwary Selvam
1
;
Nurshadia Binti Samingan
2
Author Information
1. Hospital Tunku Azizah (HTA);Universiti Malaya Medical Centre
2. Universiti Malaya Medical Centre
- Publication Type:Journal Article
- MeSH:
Adolescent;
Child;
Incidence;
Hyperthyroidism
- From:
Journal of the ASEAN Federation of Endocrine Societies
2026;41(S1):129-
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:Hyperthyroidism in children and adolescents, although uncommon, has significant effects on growth, neurodevelopment,
and quality of life. Local data in Malaysia are limited, and regional variations may influence disease presentation and
outcomes. This study aimed to determine the incidence, clinical characteristics, and treatment outcomes of paediatric
hyperthyroidism at a tertiary centre.
Methodology:A retrospective cohort study was conducted at the Paediatric Endocrine Clinic, Universiti Malaya Medical Centre, from
2014 to 2024. Patients aged below 18 years with confirmed hyperthyroidism were included. Demographic, clinical,
biochemical, and treatment data were analyzed. Descriptive statistics were used, and associations were tested using chisquare and Fisher’s exact tests, with p <0.05 considered significant.
Results:Forty-three patients were included, representing 9.7% of paediatric thyroid disorders. The cohort was predominantly
female (74.4%) and majority Malay, with a median age of 11.7 years. Most patients presented with typical features,
including palpitations (72.5%), goiter (62.5%), weight loss (45.0%), and heat intolerance (40.0%). However, atypical
presentations such as learning difficulties and psychological disturbances were also observed and, in some cases,
constituted the chief complaints. Notably, 82.5% of patients presented with severe thyrotoxicosis. Grave’s disease was the
predominant etiology. All patients received antithyroid drugs, mainly carbimazole, with 80.0% achieving disease control
and a median time to euthyroid state of 2 months. The duration of antithyroid drug therapy prior to cessation was shorter
than international recommendations, indicating a significant reduction in time to treatment completion. Relapse occurred
in 25.0% and was significantly associated with poor disease control (p = 0.014), while no significant associations were found
with demographic or biochemical factors. Definitive therapy was required in 35.0%, with older age, growth stunting, and
prior relapse identified as significant predictors (p <0.05).
Conclusion:Paediatric hyperthyroidism in this Malaysian cohort is predominantly due to Graves’ disease and frequently presents with
both classical and atypical manifestations, which may delay diagnosis. Despite a high proportion of severe thyrotoxicosis
at presentation, antithyroid drug therapy was effective, with a shorter duration to treatment cessation compared to
international standards. Poor disease control emerged as the strongest predictor of relapse, while older age, growth
stunting, and prior relapse predicted progression to definitive therapy. Early recognition and individualized management
are essential to optimize outcomes. Larger multicentre studies are needed to inform national clinical practice guidelines.
- Full text:2026080510401341437BP_P002.pdf
