Department of Neonatal Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China.
Department of Emergency, Pediatric intensive care unit, Children's Hospital of Nanjing Medical University, Nanjing, China.
BMJ Open. 2023 Jan 25;13(1):e070416. doi: 10.1136/bmjopen-2022-070416.
To describe the thyroid function test among children with abdominal distention and to follow up the treatment received by children with abnormal thyroid function.
Cross-sectional study.
A total of 1089 children (median age:30 days (IQR=21-60 days) with abdominal distension were included in this single centre study in Nanjing, China.
Thyroid dysfunction was found in 43 of 148 Hirschsprung's disease (HSCR) cases, with 3 (2.03%) having hypothyroidism, 3 (2.03%) having subclinical hypothyroidism and 3 (2.03%) having subclinical hyperthyroidism. Thyroid dysfunction was found in 206 of 941 functional abdominal distension cases, with 4 (0.43%) having hypothyroidism, 23 (2.4%) having subclinical hypothyroidism, 28 (2.9%) having subclinical hyperthyroidism and 1 (0.11%) having hyperthyroidism. Among total 65 cases (9 from HSCR, 56 from functional abdominal distension) diagnosed with thyroid diseases, 12 were treated with levothyroxine (LT-4), of which 9 were discontinued treatment at about 2 years old, and 3 were still receiving LT-4. Thirty-two cases received no treatment and thyroid function returned to normal in about 1 month. Twenty-one cases were lost during the follow-up.
The paediatrician should be vigilant for hypothyroidism when dealing with children with abdominal distension. Thyroid function should be followed up rather than simply administering a short-term levothyroxine treatment.
描述腹胀儿童的甲状腺功能检查情况,并随访甲状腺功能异常儿童的治疗情况。
横断面研究。
本单中心研究共纳入 1089 例(中位年龄:30 天(IQR=21-60 天)腹胀的儿童,来自中国南京的一个中心。
148 例先天性巨结肠(HSCR)患儿中发现甲状腺功能障碍 43 例,其中 3 例(2.03%)为甲状腺功能减退症,3 例(2.03%)为亚临床甲状腺功能减退症,3 例(2.03%)为亚临床甲状腺功能亢进症。941 例功能性腹胀患儿中发现甲状腺功能障碍 206 例,其中 4 例(0.43%)为甲状腺功能减退症,23 例(2.4%)为亚临床甲状腺功能减退症,28 例(2.9%)为亚临床甲状腺功能亢进症,1 例(0.11%)为甲状腺功能亢进症。在总共 65 例(9 例来自 HSCR,56 例来自功能性腹胀)诊断为甲状腺疾病的患者中,有 12 例接受了左甲状腺素(LT-4)治疗,其中 9 例在约 2 岁时停止治疗,3 例仍在接受 LT-4 治疗。32 例未接受治疗,约 1 个月后甲状腺功能恢复正常。21 例在随访过程中失访。
儿科医生在处理腹胀儿童时应警惕甲状腺功能减退症。应随访甲状腺功能,而不仅仅是短期给予左甲状腺素治疗。