Reference no: EM133721659

Question

Thyroid replacement therapy is required when a child has hypothyroidism. Levothyroxine is the drug of choice in children. The dose is determined based on serum thyroid hormone levels and the response of the child, including growth and development. The dose for children tends to be higher than that for adults because of the higher metabolic rate of the growing child. Regular monitoring, including growth records, is necessary to determine an accurate dose as the child grows. Maintenance levels are usually obtained at the adult dose after puberty and when active growing stops. If an antithyroid agent is needed, methimazole is the drug of choice because it is less toxic to the liver. Propylthiouracil (PTU) is no longer recommended for children. Unless other agents are ineffective, radioactive agents are not used in children because of the effects of radiation on chromosomes and developing cells. Hypercalcemia is relatively rare in children, although it may be seen with certain malignancies. If a child develops malignancy-related hypercalcemia, bisphosphonates may be used with dose adjustments based on age and weight. Serum calcium levels should be monitored closely in the child, with dose adjustments made as necessary.