{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:40:08Z","timestamp":1756320008021,"version":"3.44.0"},"reference-count":9,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,2,20]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p>Although Graves\u2019 disease is a prevalent endocrine disorder, it is rare in prepubertal patients. Here, we describe the case of a middle childhood boy diagnosed with Graves\u2019 disease. The patient experienced exophthalmos, hyperactivity and overgrowth. Endocrinological tests revealed positivity for hyperthyroidism and thyrotropin receptor antibodies. Ultrasonography revealed an enlarged thyroid gland with increased blood flow. The onset of symptoms was estimated to have occurred around the age of 4 years based on the growth chart and past facial photographs. We speculate that it took more than 2 years from onset to diagnosis in this patient. The symptoms of Graves\u2019 disease in childhood, such as hyperactivity or overgrowth, may be overlooked as problems with developmental characteristics or growth effects. Although Graves\u2019 disease is rare in this age group, it should be considered in the differential diagnosis.<\/jats:p>","DOI":"10.1136\/bcr-2025-264935","type":"journal-article","created":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T16:40:47Z","timestamp":1741020047000},"page":"e264935","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Prepubertal Graves\u2019 disease with hyperactivity and overgrowth since early childhood"],"prefix":"10.1136","volume":"18","author":[{"given":"Jihoon","family":"Park","sequence":"first","affiliation":[{"name":"Pediatrics, Ome Medical Center, Oume, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juri","family":"Kanda","sequence":"additional","affiliation":[{"name":"Pediatrics, Ome Medical Center, Oume, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kan","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Pediatrics, Ome Medical Center, Oume, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5135-4093","authenticated-orcid":false,"given":"Hiroyuki","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Pediatrics, Ome Medical Center, Oume, Tokyo, Japan"},{"name":"Pediatrics, The University of Tokyo, Bunkyo, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,3,3]]},"reference":[{"key":"2025082711005594000_18.3.e264935.1","doi-asserted-by":"crossref","first-page":"1552","DOI":"10.1056\/NEJMra1510030","article-title":"Graves\u2019 Disease","volume":"375","author":"Smith","year":"2016","journal-title":"N Engl J Med"},{"key":"2025082711005594000_18.3.e264935.2","doi-asserted-by":"publisher","DOI":"10.1159\/000430985"},{"key":"2025082711005594000_18.3.e264935.3","doi-asserted-by":"crossref","first-page":"2980","DOI":"10.1210\/jc.2018-00273","article-title":"Epidemiology of Childhood Hyperthyroidism in France: A Nationwide Population-Based Study","volume":"103","author":"Simon","year":"2018","journal-title":"J Clin Endocrinol Metab"},{"key":"2025082711005594000_18.3.e264935.4","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.EJ14-0478"},{"key":"2025082711005594000_18.3.e264935.5","doi-asserted-by":"crossref","unstructured":"DuPaul GJ , Power TJ , Anastopoulos AD , et al . ADHD rating scale-IV: checklist, norms, and clinical interpretation. New York: Guilford Press, 1998.","DOI":"10.1037\/t00680-000"},{"key":"2025082711005594000_18.3.e264935.6","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1507\/endocrj.EJ22-0154","article-title":"Establishment of reference intervals for fT3, fT4, and TSH levels in Japanese children and adolescents","volume":"70","author":"Mitsumatsu","year":"2023","journal-title":"Endocr J"},{"key":"2025082711005594000_18.3.e264935.7","doi-asserted-by":"publisher","DOI":"10.1210\/jc.85.10.3678"},{"key":"2025082711005594000_18.3.e264935.8","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1515\/jpem-2013-0288","article-title":"Clinical features at diagnosis and responses to antithyroid drugs in younger children with Graves\u2019 disease compared with adolescent patients","volume":"27","author":"Sato","year":"2014","journal-title":"J Pediatr Endocrinol Metab"},{"key":"2025082711005594000_18.3.e264935.9","doi-asserted-by":"publisher","DOI":"10.1089\/thy.1997.7.755"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-264935","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:01:02Z","timestamp":1756317662000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-264935"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":9,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3,3]]},"published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1136\/bcr-2025-264935"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-264935","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,3]]}}}