Pesce Liuska, Kopp Peter
Stead Family Department of Pediatrics, Division of Pediatric Endocrinology and Diabetes, University of Iowa Carver School of Medicine, Iowa City, Iowa 52242, USA.
Department of Internal Medicine, Division of Endocrinology, Metabolism and Molecular Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA.
Int J Pediatr Endocrinol. 2014;2014(1):8. doi: 10.1186/1687-9856-2014-8. Epub 2014 May 30.
Disorders of the thyroid gland are among the most common conditions diagnosed and managed by pediatric endocrinologists. Thyroid hormone synthesis depends on normal iodide transport and knowledge of its regulation is fundamental to understand the etiology and management of congenital and acquired thyroid conditions such as hypothyroidism and hyperthyroidism. The ability of the thyroid to concentrate iodine is also widely used as a tool for the diagnosis of thyroid diseases and in the management and follow up of the most common type of endocrine cancers: papillary and follicular thyroid cancer. More recently, the regulation of iodide transport has also been the center of attention to improve the management of poorly differentiated thyroid cancer. Iodine deficiency disorders (goiter, impaired mental development) due to insufficient nutritional intake remain a universal public health problem. Thyroid function can also be influenced by medications that contain iodide or interfere with iodide metabolism such as iodinated contrast agents, povidone, lithium and amiodarone. In addition, some environmental pollutants such as perchlorate, thiocyanate and nitrates may affect iodide transport. Furthermore, nuclear accidents increase the risk of developing thyroid cancer and the therapy used to prevent exposure to these isotopes relies on the ability of the thyroid to concentrate iodine. The array of disorders involving iodide transport affect individuals during the whole life span and, if undiagnosed or improperly managed, they can have a profound impact on growth, metabolism, cognitive development and quality of life.
甲状腺疾病是儿科内分泌学家诊断和治疗的最常见疾病之一。甲状腺激素的合成依赖于正常的碘转运，了解其调节机制对于理解先天性和后天性甲状腺疾病（如甲状腺功能减退和甲状腺功能亢进）的病因及治疗至关重要。甲状腺摄取碘的能力也被广泛用作诊断甲状腺疾病的工具，以及用于最常见的内分泌癌——乳头状和滤泡状甲状腺癌的治疗及随访。最近，碘转运的调节也成为改善低分化甲状腺癌治疗的关注焦点。由于营养摄入不足导致的碘缺乏疾病（甲状腺肿、智力发育受损）仍然是一个全球性的公共卫生问题。甲状腺功能也可能受到含碘药物或干扰碘代谢的药物（如碘化造影剂、聚维酮、锂和胺碘酮）的影响。此外，一些环境污染物（如高氯酸盐、硫氰酸盐和硝酸盐）可能会影响碘转运。此外，核事故会增加患甲状腺癌的风险，用于预防接触这些同位素的治疗依赖于甲状腺摄取碘的能力。一系列涉及碘转运的疾病会在人的整个生命周期中影响个体，如果未被诊断或处理不当，它们会对生长、代谢、认知发育和生活质量产生深远影响。
