Sidibé A T, Dembélé M, Diarra A S, Bocoum A I, Mousseni E, Ag Aboubacrine S, Traoré H A, Ag Rhaly A
Service de médecine interne, CHU de Point G, BP 2997, Bamako, Mali.
Ann Endocrinol (Paris). 2007 Jun;68(2-3):177-80. doi: 10.1016/j.ando.2007.05.003. Epub 2007 Jul 10.
Thyroid pathology is frequent in Mali, which is an endemic zone for goiter. But this pathology rarely occurs in children. The purpose of our study was to characterize this illness among children in Mali.
We report on patients aged less than 15-year old who presented with clinical signs and symptoms with hyperthyroidism at the medicine service at Hospital de Point G from January 1999 and December 2005 to determine the characteristics of hyperthyroidism.
The frequency was 9.6 per thousand (38/3972), with an average age of 12.5+/-3.34-year. The sex ratio was 3 girls/1 boys. The most common symptoms were tachycardia (n=30, 78.9%), palpitations (n=15, 34.4%). 31 patients (81.5%) presented with exophthalmoses, 93.5% being bilateral. Weight loss was present in 31.5% (n=12). Goiter was present in 37 patients (97.4%). The goiter was diffuse in 27 patients (73%) and nodular in 10 (27.%). The presence of goiter caused signs of compression in the neck in half of the cases: dyspnea and dysphonia were the most common consequences. TSH less than 0.05 microUI/1 was used to confirm the diagnosis. Graves's disease was the most common cause (n=32, 84.2%), followed by toxic adenoma (n=4, 10.5%). Other causes included toxic multinodular goiter and thyroiditis. Etiologies were independent of sex and age: (p=0.95). All patients were started on medical therapy upon diagnosis. 7 patients (18.4%) were lost to follow-up during the 6 months of treatment. Remission was obtained in 26 patients (83.9%), and relapse occurred in 5 patients (16.1%).
The frequency of hyperthyroidism in children in Mali is a problem in a goiter endemic zone like Mali. Poor general health in children and signs and symptoms of neck compression are markers of progressive disease.
甲状腺疾病在马里很常见，该国是甲状腺肿的流行地区。但这种疾病在儿童中很少发生。我们研究的目的是描述马里儿童中的这种疾病。
我们报告了1999年1月至2005年12月在Point G医院内科出现甲亢临床症状和体征的15岁以下患者，以确定甲亢的特征。
发病率为千分之9.6（38/3972），平均年龄为12.5±3.34岁。男女比例为3名女孩/1名男孩。最常见的症状是心动过速（n = 30，78.9%）、心悸（n = 15，34.4%）。31名患者（81.5%）出现突眼，93.5%为双侧。31.5%（n = 12）的患者体重减轻。37名患者（97.4%）有甲状腺肿。27名患者（73%）的甲状腺肿为弥漫性，10名（27%）为结节性。一半的病例中甲状腺肿导致颈部压迫症状：呼吸困难和声音嘶哑是最常见的后果。促甲状腺激素低于0.05微国际单位/升用于确诊。格雷夫斯病是最常见的病因（n = 32，84.2%），其次是毒性腺瘤（n = 4，10.5%）。其他病因包括毒性多结节性甲状腺肿和甲状腺炎。病因与性别和年龄无关：（p = 0.95）。所有患者确诊后均开始药物治疗。7名患者（18.4%）在6个月的治疗期间失访。26名患者（83.9%）获得缓解，5名患者（16.1%）复发。
在像马里这样的甲状腺肿流行地区，马里儿童甲亢的发病率是一个问题。儿童总体健康状况不佳以及颈部压迫症状是疾病进展的标志。
