Endocrine Abstracts

Although rare in children, Graves’ disease remains the major cause of hyperthyroidism. Positive diagnosis is easy, but management can be extremely problematic.

Case Report: We report the case of a 13 year old female patient treated for Graves’ disease since 4 years; non compliant to treatment; after adjustment of therapy and achievement of euthyroidism; a surgical cure is programmed. 24 hours after surgery, severe hypocalcaemia appeared, requiring parenteral treatment with injectable calcium for 1 month. The elements in favour of hyngry bone are a non-elevated phosphorus as well as osteopenia on bone densitometry. After 1 month of treatment with injectable calcium associated with oral calcium substitution and 1 alphacalcidal; the phosphocalcic balance improves and the treatment with injectable calcium is stopped.

Discussion: Hyperthyroidism in children is characterized by an increase in bone resorption which is reversed after total thyroidectomy where resorption decreases and bone absorption increases leading to bone hungry syndrome and severe hypocalcaemia. For this reason, it is important to assess bone damage by BMD prior to thyroidectomy to predict the risk of hungry bone syndrome and ensure adequate management