Boiro Djibril, Diédhiou Demba, Niang Babacar, Sow Djiby, Mbodj Mandiaye, Sarr Anna, Ndongo Aliou Abdoulaye, Thiongane Aliou, Guèye Modou, Thiam Lamine, Seck Ndiogou, Dieng Yaay Joor, Ba Abou, Ba Idrissa Demba, Diallo Ibrahima Mané, Ndiaye Ousmane, Diop Said Nourou
Service de Pédiatrie et Néonatologie Centre Hospitalier Abass Ndao/UCAD, Dakar, Sénégal.
Clinique Médicale II/Centre Hospitalier Abass Ndao/UCAD, Dakar, Sénégal.
Pan Afr Med J. 2017 Sep 7;28:10. doi: 10.11604/pamj.2017.28.10.13396. eCollection 2017.
Hyperthyroidism in children is rare and constitutes a problem because of its psychosomatic impact. This study aimed to present an overview of the state of knowledge on these aspects in children from Dakar.
We conducted a multicenter, descriptive study over a period of 15 years. We evaluated the epidemiological, clinical and etiologic aspects of hyperthyroidism in children.
239 patients were included in the study with a prevalence of 2.4%, a sex ratio (M/F) of 0.36 and an average age of 10.8 years. The inclusion criteria were being the eldest son in a family(26.3%), being advanced (36.9%) or delayed (12.5%) in maturation, having short stature (40.1%). It was caused by Graves' disease in 90.3% of cases with psychoaffective factor in 22.1%. On a clinical point of view tachycardia (92.4%), goiter (91.1%), exophthalmia (81.8%), weight loss (69.8%) prevailed but with bed-wetting (30.2%) and psychic manifestations (3.1%). Cardiovascular and cutaneous manifestations were positively associated with age (p < 0.05). Goiter was associated with female sex (p = 0.005), cardiovascular (p = 0.02), neuropsychic (p = 0.03), skin (p = 0.03) signs and diarrhea (p = 0.03). Free T4 was correlated with age (p = 0.007), diarrhea (p = 0.021), anxiety (p = 0.024), heart rate (p = 0.00) and Graves' disease (p = 0.04). More voluminous the goiter, higher the free T4 (p = 0.007).
Hyperthyroidism in children differs from that in adults because of induction factors, growth disturbances and enuresis. Age and sex seem to favor the clinical picture of thyrotoxicosis and its associated signs.
儿童甲状腺功能亢进症较为罕见，因其对身心的影响而成为一个问题。本研究旨在概述达喀尔儿童在这些方面的知识状况。
我们进行了一项为期15年的多中心描述性研究。我们评估了儿童甲状腺功能亢进症的流行病学、临床和病因学方面。
239名患者纳入研究，患病率为2.4%，性别比（男/女）为0.36，平均年龄为10.8岁。纳入标准包括是家庭中最大的孩子（26.3%）、发育提前（36.9%）或延迟（12.5%）、身材矮小（40.1%）。90.3%的病例由格雷夫斯病引起，22.1%有心理情感因素。从临床角度看，心动过速（92.4%）、甲状腺肿（91.1%）、突眼（81.8%）、体重减轻（69.8%）较为常见，但尿床（30.2%）和精神表现（3.1%）也存在。心血管和皮肤表现与年龄呈正相关（p<0.05）。甲状腺肿与女性性别（p=0.005）、心血管（p=0.02）、神经精神（p=0.03）、皮肤（p=0.03）体征及腹泻（p=0.03）相关。游离T4与年龄（p=0.007）、腹泻（p=0.021）、焦虑（p=0.024）、心率（p=0.00）及格雷夫斯病（p=0.04）相关。甲状腺肿越大，游离T4越高（p=0.007）。
儿童甲状腺功能亢进症与成人不同，原因在于诱发因素、生长发育障碍及尿床。年龄和性别似乎有利于甲状腺毒症的临床表现及其相关体征。
