镰状细胞贫血患儿是否存在甲状腺功能减退症被漏诊？
Are We Missing Hypothyroidism among Children with Sickle Cell Anaemia?
机构信息
Department of Paediatrics, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun, Nigeria.
出版信息
Ethiop J Health Sci. 2023 Nov;33(6):963-970. doi: 10.4314/ejhs.v33i6.6.
BACKGROUND
Children with sickle cell anaemia have been reported to have potential risk of hypothyroidism from chronic blood transfusions and probable thyroid tissue ischaemia. However, few studies on hypothyroidism status of children with sickle cell anaemia in Nigeria are available. The objective of this study was to determine the prevalence of hypothyroidism among children with sickle cell anaemia.
METHODS
A cross sectional study that assayed the thyroid hormones and thyroid stimulating hormone (TSH) of 71 children with sickle cell anaemia was conducted at Olabisi Onabanjo University Teaching Hospital Sagamu. Using age appropriate hormonal reference values, the subjects were classified into subclinical, primary and secondary hypothyroidism.
RESULTS
The mean serum TSH, Free T3, and Free T4 were comparable irrespective of age category (p > 0.05). No subject was identified to have low TSH value while 7.0% had high TSH value. Low free T3 was identified in 1.4% and 8.5% had high free T3 values. Low free T3 and free T4 were seen in 11.3% each of the subjects. The overall prevalence of primary, secondary and subclinical hypothyroidism was 0%, 0% and 4.2%, respectively.
CONCLUSION
Sub-clinical hypothyroidism does occur in Nigerian children with sickle cell anaemia. Routine screening for hypothyroidism is advocated in all children with sickle cell anaemia.
背景
有报道称，慢性输血和可能的甲状腺组织缺血会使镰状细胞贫血儿童面临潜在的甲状腺功能减退风险。然而，尼日利亚关于镰状细胞贫血儿童甲状腺功能减退症状况的研究很少。本研究旨在确定镰状细胞贫血儿童中甲状腺功能减退症的患病率。
方法
在奥拉比西·奥巴尼琼大学教学医院萨格姆，对 71 名镰状细胞贫血儿童进行了横断面研究，检测了他们的甲状腺激素和促甲状腺激素（TSH）。根据年龄适当的激素参考值，将受试者分为亚临床、原发性和继发性甲状腺功能减退症。
结果
无论年龄组如何，血清 TSH、游离 T3 和游离 T4 的平均值均无差异（p > 0.05）。没有发现 TSH 值低的受试者，而 7.0%的受试者 TSH 值高。游离 T3 低的发生率为 1.4%，游离 T3 高的发生率为 8.5%。游离 T3 和游离 T4 低的受试者分别占 11.3%。原发性、继发性和亚临床甲状腺功能减退症的总患病率分别为 0%、0%和 4.2%。
结论
亚临床甲状腺功能减退症确实发生在尼日利亚的镰状细胞贫血儿童中。建议对所有镰状细胞贫血儿童常规筛查甲状腺功能减退症。
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