Acta clinica Croatica, Vol. 62. No. 3, 2023.
Professional paper
https://doi.org/10.20471/acc.2023.62.03.17
Alternating Hypothyroidism and Hyperthyroidism in an Adolescent Boy – Do We Always Understand What Drives the Switch?
Lavinia La Grasta Sabolić
orcid.org/0000-0001-9114-7961
; Department of Pediatric Endocrinology, Diabetes and Metabolism, Sestre milosrdnice University Hospital Center, Zagreb, Croatia; Catholic University of Croatia, School of Medicine, Zagreb, Croatia
*
Marija Požgaj Šepec
; Department of Pediatric Endocrinology, Diabetes and Metabolism, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Gordana Stipančić
; Department of Pediatric Endocrinology, Diabetes and Metabolism, Sestre milosrdnice University Hospital Center, Zagreb, Croatia; University of Zagreb, School of Dental Medicine, Zagreb, Croatia
* Corresponding author.
Abstract
Alternating hypothyroidism and hyperthyroidism is a rare phenomenon, especially
among pediatric patients. It is usually related to simultaneous, unbalanced presence of stimulating
and blocking thyroid stimulating hormone receptor antibodies (TRAbs). Herein we describe thyroid
stimulating hormone (TSH) and thyroid hormone fluctuations in an adolescent boy with negative
TRAbs. A 12-year-old healthy boy exhibited alternating thyroid function, with several switches between
hypothyroidism and hyperthyroidism during almost six years of follow-up. He had persistently
elevated thyroid peroxidase antibodies, while TRAbs were repetitively negative. Due to a mild clinical
presentation, most of the time he did not require any medication. This case contributes to the spectrum
of alternating hypothyroidism and hyperthyroidism in the pediatric age and raises the question
of mechanisms involved in fluctuating thyroid function. Therapeutic decisions should be individualized
and guided by clinical manifestations and thyroid function tests, irrespective of the underlying
pathophysiology.
Keywords
Alternating thyroid function; Thyroid stimulating hormone receptor antibodies; Pediatric age
Hrčak ID:
315280
URI
Publication date:
1.11.2023.
Visits: 945 *