Exophthalmic goiter is an extremely rare condition in early childhood, but becomes more common with the approach of puberty. Plummer 1 recognizes two types of hyperthyroidism in adults, exophthalmic goiter and adenomatous goiter with hyperthyroidism. The latter is rarely found in persons tinder 25 years of age, and has never been recorded as occurring in childhood. Plummer conceives of the clinicophysiologic complex of exophthalmic goiter "as that following the administration of thyroxin, or that associated with hyperfunctioning adenomatous thyroid plus certain notable characteristic findings that can be grouped as ocular symptoms, the characteristic nervous phenomena, and the tendency to crises which may terminate in death." According to this conception, exophthalmic goiter and hyperthyroidism in children denote the same condition, although some observers have considered them as separate entities. From the study of the metabolic rate in children with exophthalmic goiter, it has been learned that the severity of the ocular
HELMHOLZ HF. EXOPHTHALMIC GOITER IN CHILDHOOD. JAMA. 1926;87(3):157–162. doi:10.1001/jama.1926.02680030021006
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