Difficultés de prise en charge de la maladie de Basedow chez l’enfant: à propos d’un cas

Adequate management of Graves’ disease in children is an area of controversy in pediatric endocrinology, while optimal duration of medical treatment inducing remission in disease as well as indications for therapeutic alternatives still needs to be determined. We report the case of a 11-year old female child with no particular past medical history., presenting with progressive weight loss associated with diarrhea. Her parents brought the child to hospital because neighbours noticed anterior cervical swelling on her. Clinical and paraclinical data helped to retain the diagnosis of Graves’ disease. The patient underwent medical treatment with carbimazole. Patient’s evolution was marked by the occurrence of thrombocytopenia, suggesting prudent administration of medical treatment. Iratherapy was indicated due to the absence of remission after 4 years of treatment. Although rare, Graves’ disease is the first cause of hyperthyroidism in children. Positive diagnosis is easy but its management may pose enormous problems. Medical treatment is based on synthetic antithyroid drugs, but they are not always innocuous, as in the case of our patient. Then subtotal thyroidectomy or radioactive iodine treatment are two therapeutic alternatives. Graves’ disease is a rare and severe disease in children posing considerable management difficulties.