children s health issues
Hyperthyroidism in Newborns and Children
Treatment
Antithyroid drugs Beta-blockers Sometimes iodine orhydrocortisone Sometimes surgery Children of all ages, including newborns, are given antithyroid drugs (such asmethimazole), which decrease the thyroid gland's production of thyroid hormones, and beta-blockers (such aspropranolol), which are drugs that slow the heart rate. Beta-blockers are used only if the heart rate is too fast or blood pressure is too high. Treatment with beta-blockers is stopped after the antithyroid drugs have taken effect. by vein if other therapies have not helped. These drugs are stopped as soon as the antibodies that cross the placenta from the mother have disappeared from the newborn’s bloodstream. Infants treated with antithyroid drugs must be monitored closely to ensure that treatment does not cause Hypothyroidism in Infants and Children , which can affect growth and development. Newborns who have neonatal hyperthyroidism almost always recover by 6 months and no longer need antithyroid drugs. Symptoms in older children treated with antithyroid drugs may eventually disappear (called remission), but symptoms may return (called relapse) in some children and they may need further treatment. Children who have a complication called thyroid storm may be given iodine drops by mouth orhydrocortisoneby vein, but thyroid storm is rare. Sometimes older children (11 years of age and older) with Graves disease need additional treatments to permanently treat the disorder. Permanent treatment (definitive therapy) may be needed if the antithyroid drugs do not work (or the child does not take them) or if the drugs are causing serious side effects. In definitive therapy, the gland is destroyed with radioactive iodine or removed with surgery. However, radioactive iodine is usually not given to children who are under age 10 and is often not effective in people who have larger thyroid glands. Therefore, surgery may be done instead for children and adolescents who have these factors. Nodules are removed surgically. Acute thyroiditis is treated with antibiotics. Subacute thyroiditis is not treated with antibiotics, but nonsteroidal anti-inflammatory drugs (NSAIDs) are given for pain. Children are not given antithyroid drugs, but beta-blockers may be given. 