Abstract
We have studied six infants and young children with hyperthyroidism whose clinical course differs from the few reports of others. Neonatal and early childhood hyperthyroidism are usually thought of as separate, rare, and transient disorders seldom requiring long term treatment. 1) Our cases have not been transient: 2) they have occurred in families with a high incidence of adult Graves disease.
Four were born with Graves disease. Three continue to be hyperthyroid at ages 1, 5, and 6 years. Two developed Graves disease at ages 3 and 8 years and continue on anti-thyroid medication. Graves disease occurred in five of the six mothers and was apparent during gestation in four. The sixth mother, mother of a neonatal case, has never had overt Graves disease, but female members of four generations have had Graves disease. In all six kindreds there was a direct maternal line of affected patients for two or more generations.
Selected families were studied for the presence of latent thyroid disease using measurements of thyroid hormonal iodine. Some were screened for thyroid markers: PTC tasting and circulting thyroid antibodies. A rare unsuspected case was detected, but no thyroid marker pattern developed.
The occurrence of Graves disease in the very young in families with a high incidence of Graves disease suggests a hereditary factor. No goitrogens or use of medications were common to the families. We suggest that there is biologic unity between neonatal, early childhood and adult Graves disease. This unity is best explained by the presence of an autosomal dominant determinant with a predilection for the female.
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Hollingsworth, D., Mabry, C. & Eckerd, J. Neonatal and early childhood hyperthyroidism: An expression of hereditary Graves disease. Pediatr Res 5, 399–400 (1971). https://doi.org/10.1203/00006450-197108000-00119
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DOI: https://doi.org/10.1203/00006450-197108000-00119