Evolution over time of pediatric hyperthyroidism

French experts followed pediatric subjects with hyperthyroidism over a period of 10 years to see how the frequency of this thyroid dysfunction was trending over time. The results indicated that the incidence of pediatric hyperthyroidism has increased over the years, and they hypothesized relationships between this increase and possible factors that have promoted its occurrence.

Pediatric hyperthyroidism is caused in most cases by Graves’ disease, which develops by mechanisms of autoimmunity and is rare in children. Data on the prevalence of this disease are few, and its incidence within specific geographical areas is unknown. With this in mind, Le Moal and colleagues performed a study to describe for the first time trends in the frequency of occurrence of pediatric hyperthyroidism in France. In addition, the authors also analyzed its distribution over the territory to identify any environmental factors that favor its development. This was a population-based observational study, based on the analysis of data in the National Health System archive, referring to the period between 2008 and 2017, and collected throughout the national territory of France. Subjects with an indicator associated with the occurrence of new cases of treated hyperthyroidism in children and adolescents aged 6 months to 17.9 years were identified. Cases were placed in relation to precise geographic areas, referring to Departments of residence. A descriptive analysis of incidence by sex, age, and year was performed, and a spatiotemporal model was used to estimate frequencies of occurrence at the departmental level. A total of 4734 new cases were identified, 80% female subjects (n=3787) and 20% male subjects (n=947). The incidence was 3.35 (95% confidence interval 3.26-3.45) per 100,000 person-years, throughout the period considered in the research. The authors estimated that from 2008 to 2017 the incidence increased by 30 percent (19.0 percent; 42.3 percent). They also verified that the annual incidence increased incrementally over the 10 years considered, in both males and females, regardless of age groups and department of residence. On the other hand, the spatial pattern highlighted the marked heterogeneity in the risk of developing pediatric hyperthyroidism throughout France.

In the conclusions, the authors pointed out that the results of their study showed an increase in the incidence of pediatric hyperthyroidism, and this could reflect changes in the interaction between genetic and environmental factors distributed heterogeneously across the territory.

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