Ozden Ayşe, Doneray Hakan
Department of Pediatric Endocrinology, Ataturk University Faculty of Medicine, Erzurum, Türkiye.
Eurasian J Med. 2024 Oct 23;56(3):178-181. doi: 10.5152/eurasianjmed.2024.24541.
Hashimoto's thyroiditis (HT) is the most common cause of goiter and acquired hypothyroidism in children after iodine deficiency. In this study, clinical and laboratory findings and follow-up results of children diagnosed with HT are presented. The data of cases diagnosed with HT between 2004 and 2022 in 2 centers in Erzurum were evaluated retrospectively. Of the 81 children with HT whose ages ranged from 3 to 18 years (11.24 ± 3.72), 67 (82.7%) were girls and 14 (17.3%) were boys. The most common symptoms were neck swelling (37%), fatigue (23.5%), and hair loss (23.5%). There was a family history of HT in 12 cases (9.9%). Fifty-one (63%) of the cases were in the pubertal period and 30 (37%) were in the prepubertal period. There was no goiter in 36 (44.4%) of the patients, second degree goiter in 24 (29.6%), first degree goiter in 14 (17.3%), and third degree goiter in 7 (8.7%). Twenty-two (27.2%) of the cases were euthyroid, 27 (33.3%) were subclinical hypothyroidism, 23 (28.4%) were hypothyroidism, and 9 (11.1%) were hyperthyroidism. While 18 (22.2%) of the cases were followed up without medication, 59 (72.8%) were given levothyroxine and 4 (5%) were given methimazole. The mean follow-up time was 32.1 ± 33.7 months. The study's findings suggest that HT is more common in girls and occurs more frequently after puberty. A personal or family history of an autoimmune disease may be a warning sign for HT. Additionally, HT should be kept in mind in the diferential diagnosis of children presenting with complaints of neck swelling, fatigue, and hair loss.
桥本甲状腺炎(HT)是碘缺乏症之后儿童甲状腺肿大和后天性甲状腺功能减退的最常见原因。在本研究中,呈现了诊断为HT的儿童的临床和实验室检查结果以及随访结果。对2004年至2022年期间在埃尔祖鲁姆的2个中心诊断为HT的病例数据进行了回顾性评估。在81名年龄在3至18岁(11.24±3.72)的HT儿童中,67名(82.7%)为女孩,14名(17.3%)为男孩。最常见的症状是颈部肿胀(37%)、疲劳(23.5%)和脱发(23.5%)。12例(9.9%)有HT家族史。51例(63%)处于青春期,30例(37%)处于青春期前。36例(44.4%)患者无甲状腺肿大,24例(29.6%)为二度甲状腺肿大,14例(17.3%)为一度甲状腺肿大,7例(8.7%)为三度甲状腺肿大。22例(27.2%)病例甲状腺功能正常,27例(33.3%)为亚临床甲状腺功能减退,23例(28.4%)为甲状腺功能减退,9例(11.1%)为甲状腺功能亢进。18例(22.2%)病例未用药进行随访,59例(72.8%)给予左甲状腺素,4例(5%)给予甲巯咪唑。平均随访时间为32.1±33.7个月。该研究结果表明,HT在女孩中更常见,且在青春期后更频繁发生。自身免疫性疾病的个人或家族史可能是HT的一个警示信号。此外,对于出现颈部肿胀、疲劳和脱发症状的儿童进行鉴别诊断时应考虑到HT。