Abstract
juvenile thyrotoxicosis. Single-dose antithyroid medicine should be reserved for those children in whom a perchlorate discharge test demonstrates suppressibility while under the influence of the thioamides.s There is disagreement concerning the etiology of thyroid Although in one patient' a high T, level in the presence of a normal T, concentration correlated with an episode of storm, further data have shown no significant difference inT, levels between uncomplicated thyrotoxicosis and thyroid storm. Circulating thyroid hormones increase after radioiodine therapy; and the very high levels seen in our patient would tend to support a relationship of such therapy to the clinical manifestations of Propranolol has been found to be an excellent drug in the control of thyrotoxic manifestations in adults, and at least one other child with an episode of storm has been successfully managed with this beta-adrenergic-blocking agent.' The wide variation in the dose of propranolol required for control-s mandates very careful clinical follow-up of children treated with radioiodine. When significant side effects to the thioamides require a change of therapy, it may be best to attempt to use other drugs, such as perchlorate or lithium, to control thyrotoxicity prior to ablative therapy for juvenile hyperthyroidism.
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