Panamonta O, Kirdpon W, Somsapt P
Department of Pediatrics, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand.
Southeast Asian J Trop Med Public Health. 2001 Sep;32(3):631-5.
Forty-seven pediatric patients with autoimmune thyroiditis were followed for an average of 5.18+/-2.89 years. The diagnosis was based on a firm goiter and a positive test for antithyroid antibodies. Initially, 23 patients had euthyroidism, 11 overt hypothyroidism, 6 compensated hypothyroidism and 7 with low TSH. All patients had clinical euthyroidism, except two who had overt hypothyroidism. The thyroid function tests, the size of the thyroid gland and the thyroid antibodies were regularly evaluated. After the follow-up, 26 patients had untreated euthyroidism, 12 with overt hypothyroidism received eltroxin for maintenance of euthyroidism, while 4 had compensated hypothyroidism and 5 low TSH levels. All had clinical euthyroid. The thyroid size was reduced in 12 patients (26%) while 4 (9%) had normal-sized gland. The goiter size in 35 patients (74%) remained unchanged. The antithyroglobulin and antimicrosomal antibody titers fluctuated higher in patients with overt hypothyroidism. Eltroxin was given only to those having overt hypothyroidism with diminished goiter size in 8 patients (73%).
47例自身免疫性甲状腺炎患儿平均随访5.18±2.89年。诊断基于明确的甲状腺肿大和抗甲状腺抗体检测阳性。最初,23例患者甲状腺功能正常,11例为显性甲状腺功能减退,6例为代偿性甲状腺功能减退,7例促甲状腺激素水平低。除2例显性甲状腺功能减退患者外,所有患者临床甲状腺功能均正常。定期评估甲状腺功能检查、甲状腺大小和甲状腺抗体。随访后,26例患者未经治疗甲状腺功能正常,12例显性甲状腺功能减退患者接受左旋甲状腺素以维持甲状腺功能正常,4例为代偿性甲状腺功能减退,5例促甲状腺激素水平低。所有患者临床甲状腺功能均正常。12例患者(26%)甲状腺大小缩小,4例(9%)甲状腺大小正常。35例患者(74%)甲状腺肿大大小未变。显性甲状腺功能减退患者抗甲状腺球蛋白和抗微粒体抗体滴度波动更大。仅8例(73%)显性甲状腺功能减退且甲状腺肿大缩小的患者给予了左旋甲状腺素。