TY - CHAP M1 - Book, Section TI - Thyroid Disorders A1 - Furtado, Nicholas A2 - Schafermeyer, Robert A2 - Tenenbein, Milton A2 - Macias, Charles G. A2 - Sharieff, Ghazala Q. A2 - Yamamoto, Loren G. Y1 - 2014 N1 - T2 - Strange and Schafermeyer's Pediatric Emergency Medicine, 4e AB - The most common disorder causing thyrotoxicosis in children is Graves' disease.Thyroid hormones upregulate β-adrenergic receptors causing symptoms of sympathetic nervous system overactivity.Signs of sympathetic hyperactivity include tremor, brisk deep tendon reflexes, tachycardia, supraventricular tachycardia, flow murmur, overactive precordium, and a widened pulse pressure. Other cardiac disturbances such as atrial fibrillation and congestive heart failure (CHF) may also occur.Precipitating factors for thyroid storm in a patient with hyperthyroidism are thyroid surgery, withdrawal of antithyroid medications, radioiodine therapy, palpation of a goiter, iodinated contrast dyes, and stress.Thyroid storm is suggested by severe hyperpyrexia, atrial dysrhythmia, CHF, delirium or psychosis, severe gastrointestinal hyperactivity, and hepatic dysfunction with jaundice.Treatment consists of antithyroid drug propylthiouracil (PTU) at a dosage of 175 mg/m2/day or 4 to 6 mg/kg/day at 6- or 8-hour intervals, iodine therapy started 1 hour after antithyroid medication is initiated, β-adrenergic blockade with propranolol, 10 to 20 mg every 8 to 12 hours, and supportive management. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/11/11 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1105684199 ER -