Özen Samim, Berk Ömer, Şimşek Damla Gökşen, Darcan Sükran
Mersin Children's Hospital, Pediatric Endocrinology Unit, Mersin, Turkey.
J Clin Res Pediatr Endocrinol. 2011;3(4):192-7. doi: 10.4274/jcrpe.425.
The aim of this study was to evaluate the clinical course of Hashimoto's thyroiditis (HT) in children and adolescents and the effects of levothyroxine therapy on the clinical course and laboratory findings.
The clinical and laboratory data of 101 patients with HT at presentation and during a three-year follow-up period were retrospectively evaluated using patient records.
The mean age of the patients at the time of diagnosis was 12.3 ± 2.90 years and female/male ratio was 5.7/1. The complaint at the time of hospital presentation was goiter in 57.8% of the patients. At baseline, 36.7% of the patients were euthyroid, whereas 32.7% had subclinical hypothyroidism, 16.6 % of subjects were evaluated as hypothyroid. Twelve of the 28 patients who were initially euthyroid and not receiving therapy developed subclinical or overt hypothyroidism during the first 18 months of the follow-up period and were started on thyroid medication. At presentation, the mean anti-thyroglobulin (anti-Tg) and anti-thyroperoxidase antibody levels were 450 ± 725 IU/mL and 392 ± 428 IU/mL, respectively and at the end of the follow-up period, a significant decrease was observed in the anti-Tg levels of patients receiving levothyroxine from the beginning.
Thyroid functions of the patients with HT should be monitored periodically for hypothyroidism. Levothyroxine therapy may positively affect the clinical course of the disease and the antibody titers.
本研究旨在评估儿童和青少年桥本甲状腺炎(HT)的临床病程以及左甲状腺素治疗对临床病程和实验室检查结果的影响。
使用患者记录对101例HT患者就诊时及三年随访期内的临床和实验室数据进行回顾性评估。
患者诊断时的平均年龄为12.3±2.90岁,女性/男性比例为5.7/1。就诊时57.8%的患者主诉为甲状腺肿大。基线时,36.7%的患者甲状腺功能正常,32.7%有亚临床甲状腺功能减退,16.6%的受试者被评估为甲状腺功能减退。最初甲状腺功能正常且未接受治疗的28例患者中有12例在随访期的前18个月内发展为亚临床或显性甲状腺功能减退,并开始接受甲状腺药物治疗。就诊时,抗甲状腺球蛋白(抗-Tg)和抗甲状腺过氧化物酶抗体水平的平均值分别为450±725 IU/mL和392±428 IU/mL,在随访期末,从一开始就接受左甲状腺素治疗的患者的抗-Tg水平显著下降。
应定期监测HT患者的甲状腺功能以筛查甲状腺功能减退。左甲状腺素治疗可能对疾病的临床病程和抗体滴度产生积极影响。