A Case with Hyperthyroidism Who Had Been Treated with Thyroid Hormone Because
of Congenital Hypothyroidism |
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Authors: | Kiyoko Otsubo Michiyo Mizota Kazuko Hizukuri Izumi Tamada Shiu Arima Seigo Ono Yoshifumi Kawano |
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Institution: | 1. Department of Pediatrics, Faculty of Medicine, Kagoshima University, Kagoshima, Japan;2. Ibusuki Public Health Center, Kagoshima, Japan |
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Abstract: | We encountered a case with hyperthyroidism at the age of 14 who had been
diagnosed with congenital hypothyroidism (CH) and had received thyroid hormone replacement
therapy. At the age of 16 d, the patient was referred to our hospital because of positive
results at neonatal screening for CH. Serum level of TSH was 91.0 μU/ml
and serum level of T4 was 6.9 μg/dl. The patient was diagnosed as having
hypothyroidism, and hormone replacement therapy was started. Thereafter the dosage of
thyroid hormone was adjusted and increased gradually as he grew to a maximum dose of 110
μg/day at the age of 11. Until the age of 13, the patient’s serum
levels of TSH were within the normal range; then, at the age of 13 yr and 4 mo, his serum
level of TSH dropped to a level below the detectable range. The dosage of administered
thyroid hormone was tapered off and eventually eliminated at the age of 14. A thyroid scan
and a radioactive iodine uptake test demonstrated a diffuse goiter with homogeneous uptake
of radioactive iodine; the uptake rate was 60% at 24 h, and the serum level of TSH
receptor antibody (TRAb) was 62.5% at that time. Administration of an antithyroid drug was
started after confirmation that our patient had developed hyperthyroidism. There have been
no case reports similar to our case. |
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Keywords: | congenital hypothyroidism neonatal screening hyperthyroidism |
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