A Case of Graves Disease with Kyphosis by Osteoporosis

ABSTRACT

Graves disease is the most common clinical feature of hyperthyroidism in childhood. Clinical manifestations include emotional lability, hyperactivity, tremor, excessive sweating, exophthalmos and weight loss. In Graves disease, osteoporosis could occur because of a disturbance of mineral homeostasis which rarely develops from reduced calcium absorption of the gastrointestinal tract and increased urinary calcium excretion related to an increased bone resorption. We report a case of Graves disease with spinal deformity caused by osteoporosis in a 12-year-old female who was presented with back pain, anterior neck mass and kyphosis. Laboratory findings revealed hyperthyroidsm, hypercalciuria in 24-hour urine and normal serum parathyroid hormone. On radiologic examination, multiple osteoporosis and a spinal compression fracture were observed. The bone mineral density was decreased at the hip and lumbar spine on the bone densitometry. After initiating antithyroid drug, calcitonin and vitamin D, she returned to a euthyroid state and her back pain was improved. Bone density was also increased one year later.