Endocrine Abstracts

Graves’ disease is a rare and severe disease that most often affects older children and is predominantly female. The diagnosis is made in the presence of a clinical picture very suggestive of thyrotoxicosis, confirmed by biological and radiological tests. We present the case of an 11-year-old female patient who presented with a moderate presented of basedow with an ultrasound appearance of thyroiditis for which scintigraphy was helpful in the diagnosis. Female patient, 11 years old with no history, has been suffering from moderate weight loss for 2 months without any other signs of thyrotoxicosis. On clinical examination: bilateral exophthalmos, normocadic at 78 bpm non palpable thyroid. On clinical examination: bilateral exophthalmos, normocadic at 78 bpm non palpable thyroid. On workup: TSH < 0,05 Mui/l; T4L: 20,8 (N:9-19) pmol/l; Cervical echography: aspect of a thyroiditis. diagnosis doubt and therapeutic necessity, a scintigraphy was performed showing a diffuse and homogeneous fixation. the patient had been put on carbimazol 20 mg/d. The difference between Graves’ disease and thyroiditis is not always trivial in view of the clinical manifestations during the Hashi toxicosis phase and the ultrasound appearance, the interpretation of which remains operator dependent. In such conditions, the use of anti-thyroid antibodies or scintigraphy can play a decisive role. Indeed, in Graves’ disease the scan image appears diffuse and homogeneous unlike in thyroiditis where the image appears white. Thyroid scintigraphy is one of the definitive diagnostic tools, especially when there is clinical and sonographic confusion between the two conditions.