The aftermath of childhood hyperthyroidism.

Long-term consequences of juvenile hyperthyroidism can result both from the disease itself and from the treatment used. In most children with thyrotoxicosis, the manifestations of the disease on bone metabolism, cardiac function and neurological and psychiatric findings are related to the hyperthyroid status and disappear with restoration to the euthyroid state. Late late consequences are unknown. Permanent adverse effects are due to the treatments used. Antithyroid drugs are associated with mild adverse consequences in 28% of the patients treated. Serious complications, such as agranulocytosis, aplastic anemia and death, have been reported. Review of surgical complications showed the incidence of permanent hypoparathyroidism 2%, permanent cord paralysis 2% and approximately one death for each 1,000 thyroidectomies. The adverse effects of radioiodine therapy remain largely theoretical, when children were treated with ablative doses of I131. Childhood ophthalmopathy improves after radioiodine therapy.