Hyperthyroid ec Grave's D...

a 3 years 10 months girl, complaining of lumps on the right and left front of the neck that have been getting bigger in the last 1 year, the parents mentioned that the child sweats a lot, cannot stand hot weather, weight loss but increased appetite. The child also has difficulty sleeping and wakes up easily. Previous medical history was unknown. The child was born full term with a birth weight of 3500 grams with normal motor and mental milestones. This child is the first child with a history of maternal pregnancy and childbirth without complications. There was no family history of similar complaints. PF TTV was normal, no tremor was found. TB 106cm, BW 19kg, bilateral exopthalmus, diffuse thyroid enlargement grade 1B (WHO), soft and no nodules, Bone Age 4.3 Years (Greulich-Dyle). from the results of the laboratory examination obtained hemoglobin 14.6 grams / dL, hematocrit 42.6%, leukocytes 7000 / mm, platelets 406,000 / mm, TSH 0.03 IU / mL, T3 2.31 ng / mL, Free T4 2.25 ng / mL, AMA 7,053.94 IU / mL, TSH Binding inhobitory immunoglobulin 31.62%. The patient was diagnosed with hyperthyroid et causa grave disease.