graves disease is a auti immune disorder with hyperthyroidism, induced by tsh receptors stimulating antibodies,this disease is more common 4 to 8 times in female patients and less common in children,may present as transient neonatal hyperthyroidism because of placental transmission of antibodies. a 6 year old child presented with goiter without exophthalamos,irriatable,weak with good appetite but unable to concentrate on his studies, and mental funtions were intact. o/e painless,nontender swelling in thyroid region is present,no tremor no eye changes noted,hr was110/minuts diagnosis..
a tsh.was within normal limit b.t3 and t4 both were increased cfnac and usg not conclusive d,serum calcium and sugar within normal limit mangement includes.. 1.antithyroid drugs a.methimazole to control symtoms and prior to surgery to make euthyroid b.ptu propyl thiouracil ..usualy not indicate in children…
