Programa de Endocrinología Pediátrica, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
Programa de Medicina, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
Biomedica. 2022 Jun 1;42(2):342-354. doi: 10.7705/biomedica.6244.
Introduction: Hyperthyroidism is a heterogeneous condition characterized by the excessive production of thyroid hormones. It represents a diagnostic and therapeutic challenge. Objective: To describe the clinical and paraclinical characteristics and the evolution and differences between the main etiologies in patients with hyperthyroidism treated by the Pediatric Endocrinology Service at the Hospital Universitario San Vicente Fundación in Medellín, Colombia, between July 1st., 2015, and June 30th., 2020. Materials and methods: We conducted a cross-sectional observational study with retrospective data collection. Results: We included 54 patients with a mean age of 11.9 years, 72.2% of whom were female; 85.2% had no history of comorbidities related to autoimmunity; 11.1% had a family history of Graves’ disease, and 29.6% of other thyroid diseases. Goiter was the most frequent clinical manifestation (83.3%) and 92.6% of the patients received treatment with methimazole, 79.6% required beta-blockers, and 11.2% additional drug therapy. Adverse drug reactions occurred in 16.7% of the patients and in 20.4% there was a resolution of hyperthyroidism (spontaneous: 9.3%; after radio-iodine ablation: 9.3%, and after surgery: 1.9%). Conclusion: Hyperthyroidism is a disease with diverse clinical manifestations. Its most frequent cause is Graves’ disease followed by hashitoxicosis, which in this study had a higher frequency than that reported in the literature. The duration and side effects of pharmacological treatment were similar to those previously reported, but the higher frequency of agranulocytosis is noteworthy.
甲状腺功能亢进症是一种由甲状腺激素过度产生引起的异质性疾病。它是一种诊断和治疗上的挑战。目的：描述 2015 年 7 月 1 日至 2020 年 6 月 30 日期间在哥伦比亚麦德林的 San Vicente Fundación 大学医院儿科内分泌科接受治疗的甲状腺功能亢进症患者的临床和实验室特征以及主要病因之间的演变和差异。材料和方法：我们进行了一项回顾性数据收集的横断面观察性研究。结果：我们纳入了 54 例平均年龄为 11.9 岁的患者，其中 72.2%为女性；85.2%无自身免疫性相关合并症史；11.1%有格雷夫斯病家族史，29.6%有其他甲状腺疾病史。甲状腺肿是最常见的临床表现（83.3%），92.6%的患者接受甲巯咪唑治疗，79.6%需要使用β受体阻滞剂，11.2%需要额外的药物治疗。16.7%的患者发生药物不良反应，20.4%的患者甲状腺功能亢进症缓解（自发缓解：9.3%；放射性碘消融后缓解：9.3%，手术后缓解：1.9%）。结论：甲状腺功能亢进症是一种临床表现多样的疾病。最常见的病因是格雷夫斯病，其次是毒性多结节性甲状腺肿，在本研究中其发病率高于文献报道。药物治疗的持续时间和不良反应与之前报道的相似，但粒细胞缺乏症的更高发病率值得注意。
