Dilated cardiomyopathy with Graves disease in a young child
Graves disease (GD) can lead to complications such as cardiac arrhythmia and heart failure. Although dilated cardiomyopathy (DCMP) has been occasionally reported in adults with GD, it is rare in children. We present the case of a 32-month-old boy with DCMP due to GD. He presented with irritability,...
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| Format: | Article |
| Language: | English |
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Korean Society of Pediatric Endocrinology
2016-06-01
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| Series: | Annals of Pediatric Endocrinology & Metabolism |
| Subjects: | |
| Online Access: | http://e-apem.org/upload/pdf/apem-21-92.pdf |
| _version_ | 1818248900701585408 |
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| author | Yu Jung Choi Jun Ho Jang So Hyun Park Jin-Hee Oh Dae Kyun Koh |
| author_facet | Yu Jung Choi Jun Ho Jang So Hyun Park Jin-Hee Oh Dae Kyun Koh |
| author_sort | Yu Jung Choi |
| collection | DOAJ |
| description | Graves disease (GD) can lead to complications such as cardiac arrhythmia and heart failure. Although dilated cardiomyopathy (DCMP) has been occasionally reported in adults with GD, it is rare in children. We present the case of a 32-month-old boy with DCMP due to GD. He presented with irritability, vomiting, and diarrhea. He also had a history of weight loss over the past few months. On physical examination, he had tachycardia without fever, a mild diffuse goiter, and hepatomegaly. The chest radiograph showed cardiomegaly with pulmonary edema, while the echocardiography revealed a dilated left ventricle with an ejection fraction (EF) of 28%. The thyroid function test (TFT) showed elevated serum T3 and decreased thyroid stimulating hormone (TSH) levels. The TSH receptor autoantibody titer was elevated. He was diagnosed with DCMP with GD; treatment with methylprednisolone, diuretics, inotropics, and methimazole was initiated. The EF improved after the TFT normalized. At follow-up several months later, although the TFT results again showed evidence of hyperthyroidism, his EF had not deteriorated. His cardiac function continues to remain normal 1.5 months after treatment was started, although he still has elevated T3 and high TSH receptor antibody titer levels due to poor compliance with drug therapy. To summarize, we report a young child with GD-induced DCMP who recovered completely with medical therapy and, even though the hyperthyroidism recurred several months later, there was no relapse of the DCMP. |
| first_indexed | 2024-12-12T15:27:57Z |
| format | Article |
| id | doaj.art-827f67ab5f1548319399cfdc82c45862 |
| institution | Directory Open Access Journal |
| issn | 2287-1012 2287-1292 |
| language | English |
| last_indexed | 2024-12-12T15:27:57Z |
| publishDate | 2016-06-01 |
| publisher | Korean Society of Pediatric Endocrinology |
| record_format | Article |
| series | Annals of Pediatric Endocrinology & Metabolism |
| spelling | doaj.art-827f67ab5f1548319399cfdc82c458622022-12-22T00:20:11ZengKorean Society of Pediatric EndocrinologyAnnals of Pediatric Endocrinology & Metabolism2287-10122287-12922016-06-01212929510.6065/apem.2016.21.2.92652Dilated cardiomyopathy with Graves disease in a young childYu Jung Choi0Jun Ho Jang1So Hyun Park2Jin-Hee Oh3Dae Kyun Koh4Department of Pediatrics, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.Department of Pediatrics, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.Department of Pediatrics, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.Department of Pediatrics, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.Department of Pediatrics, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.Graves disease (GD) can lead to complications such as cardiac arrhythmia and heart failure. Although dilated cardiomyopathy (DCMP) has been occasionally reported in adults with GD, it is rare in children. We present the case of a 32-month-old boy with DCMP due to GD. He presented with irritability, vomiting, and diarrhea. He also had a history of weight loss over the past few months. On physical examination, he had tachycardia without fever, a mild diffuse goiter, and hepatomegaly. The chest radiograph showed cardiomegaly with pulmonary edema, while the echocardiography revealed a dilated left ventricle with an ejection fraction (EF) of 28%. The thyroid function test (TFT) showed elevated serum T3 and decreased thyroid stimulating hormone (TSH) levels. The TSH receptor autoantibody titer was elevated. He was diagnosed with DCMP with GD; treatment with methylprednisolone, diuretics, inotropics, and methimazole was initiated. The EF improved after the TFT normalized. At follow-up several months later, although the TFT results again showed evidence of hyperthyroidism, his EF had not deteriorated. His cardiac function continues to remain normal 1.5 months after treatment was started, although he still has elevated T3 and high TSH receptor antibody titer levels due to poor compliance with drug therapy. To summarize, we report a young child with GD-induced DCMP who recovered completely with medical therapy and, even though the hyperthyroidism recurred several months later, there was no relapse of the DCMP.http://e-apem.org/upload/pdf/apem-21-92.pdfDilated cardiomyopathyChildGraves disease |
| spellingShingle | Yu Jung Choi Jun Ho Jang So Hyun Park Jin-Hee Oh Dae Kyun Koh Dilated cardiomyopathy with Graves disease in a young child Annals of Pediatric Endocrinology & Metabolism Dilated cardiomyopathy Child Graves disease |
| title | Dilated cardiomyopathy with Graves disease in a young child |
| title_full | Dilated cardiomyopathy with Graves disease in a young child |
| title_fullStr | Dilated cardiomyopathy with Graves disease in a young child |
| title_full_unstemmed | Dilated cardiomyopathy with Graves disease in a young child |
| title_short | Dilated cardiomyopathy with Graves disease in a young child |
| title_sort | dilated cardiomyopathy with graves disease in a young child |
| topic | Dilated cardiomyopathy Child Graves disease |
| url | http://e-apem.org/upload/pdf/apem-21-92.pdf |
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