{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:49:12Z","timestamp":1747198152468,"version":"3.40.5"},"reference-count":15,"publisher":"Walter de Gruyter GmbH","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpem-2023-0331_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Graves\u2019 disease (GD) is a rare auto-immune disorder in pediatric population. The association between GD and thymic hyperplasia was rarely reported in children. Diagnosis and management of GD are challenging in children.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2023-0331_abs_002\">\n                  <jats:title>Case presentation<\/jats:title>\n                  <jats:p>This report presents the case of a 5-year-old girl with a personal history of asthma and congenital bilateral isolated clinical anophthalmia who presented with\u00a0acute congestive heart failure, sinus tachycardia and atypical signs of orbitopathy with edema and erythema of the lower right eyelid and excessive tearing. The diagnosis of\u00a0GD was based on detecting a suppression of serum TSH\u00a0level and the presence of high titers of TRAbs. Relapse occurred after 10\u00a0months of antithyroid drugs with chief\u00a0complaints of palpitations, dyspnea and dysphagia. Computed tomography showed heterogeneous anterior mediastinal mass with no invasion into the surrounding tissue. The marked shrinkage of the mass after radioiodine therapy supported the diagnosis of thymic hyperplasia associated with GD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2023-0331_abs_003\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The presence of clinical anophthalmia may\u00a0be a confusing factor for the diagnosis of Graves\u02bc ophthalmopathy. Recognition of the association between GD and thymic hyperplasia would avoid invasive diagnostic procedures and unnecessary surgical resection. Radioiodine therapy may be used in young children with repeated relapses of GD.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpem-2023-0331","type":"journal-article","created":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T15:20:30Z","timestamp":1703604030000},"page":"174-178","source":"Crossref","is-referenced-by-count":0,"title":["Unusual onset of Graves\u2019 disease associated with thymic hyperplasia in a 5-year-old girl with congenital bilateral clinical anophthalmia: diagnostic and therapeutic challenges"],"prefix":"10.1515","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2674-6049","authenticated-orcid":false,"given":"Rania","family":"Ben Rabeh","sequence":"first","affiliation":[{"name":"Faculty of Medicine of Tunis , University Tunis El Manar , Tunis , Tunisia"},{"name":"Pediatric Department C , Bechir Hamza Children\u2019s Hospital Tunis , Tunis , Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Bouzidi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine of Tunis , University Tunis El Manar , Tunis , Tunisia"},{"name":"Pediatric Department C , Bechir Hamza Children\u2019s Hospital Tunis , Tunis , Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rim","family":"Hamdi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine of Tunis , University Tunis El Manar , Tunis , Tunisia"},{"name":"Pediatric Department C , Bechir Hamza Children\u2019s Hospital Tunis , Tunis , Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nada","family":"Missaoui","sequence":"additional","affiliation":[{"name":"Faculty of Medicine of Tunis , University Tunis El Manar , Tunis , Tunisia"},{"name":"Pediatric Department C , Bechir Hamza Children\u2019s Hospital Tunis , Tunis , Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olfa","family":"Bouyahia","sequence":"additional","affiliation":[{"name":"Faculty of Medicine of Tunis , University Tunis El Manar , Tunis , Tunisia"},{"name":"Pediatric Department C , Bechir Hamza Children\u2019s Hospital Tunis , Tunis , Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonia","family":"Mazigh","sequence":"additional","affiliation":[{"name":"Faculty of Medicine of Tunis , University Tunis El Manar , Tunis , Tunisia"},{"name":"Pediatric Department C , Bechir Hamza Children\u2019s Hospital Tunis , Tunis , Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samir","family":"Boukthir","sequence":"additional","affiliation":[{"name":"Faculty of Medicine of Tunis , University Tunis El Manar , Tunis , Tunisia"},{"name":"Pediatric Department C , Bechir Hamza Children\u2019s Hospital Tunis , Tunis , Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2023,12,27]]},"reference":[{"key":"2024021417134775802_j_jpem-2023-0331_ref_001","doi-asserted-by":"crossref","unstructured":"Metwalley, KA, Farghaly, HS. 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