Endocrine Abstracts

The incidence of childhood thyrotoxicosis in the UK and Ireland is unknown. The commonest cause worldwide is Graves’ disease (60–90% of cases), with reported incidences varying from 0.79 (Denmark) to 6.5 (Hong Kong) per 100,000 pop./yr. Mean age at diagnosis is reported as 11.3 years with a F:M ratio of 5.5:1. Some countries have recently reported an increasing incidence.

To ascertain the UK and Ireland incidence of childhood thyrotoxicosis and to describe the presenting features, we have established a national prospective surveillance study from September 2004 to September 2005, coordinated by The British Paediatric Surveillance Unit (BPSU). All paediatricians across the UK and Ireland are requested monthly by the BPSU to report new cases <16 yrs of age. Presenting features of each case are then obtained by questionnaire.

In the first 10 months there were 116 confirmed cases of childhood thyrotoxicosis in the UK and 4 confirmed cases in Ireland. Confirmation of a further 53 reports from the UK and 2 from Ireland is awaited. Currently this estimates the annual incidence at 1.71 per 100,000 (0–15 yr olds) for UK and Ireland. The underlying causes are: Graves’ 74%; Hashimoto’s 8%; Congenital 10%. In Graves’ disease the mean age at diagnosis is 12.3 yrs. The were 32 prepubertal cases (F:M ratio of 1.5:1) and 58 post-pubarche cases (F:M ratio of 3.2:1). A variety of presenting symptoms (all causes) were reported with the commonest being weight loss (55%) and ‘change in behaviour’ (47%). The commonest signs were goitre(68%) and tremor(62%).

These preliminary findings show a similar incidence of Graves’ disease to other countries in Europe, and confirm a sharp increase in the incidence in girls after the onset of puberty.