Safar A, Job J C
Arch Fr Pediatr. 1976 May;33(5):431-43.
27 hypothyroid infants of children, with a low iodine uptake in spite of a thyroid gland or thyroid tissue in normal pretracheal place, have been studied. 21 cases are related to primary thyroid involvement leading to vanishing iodine or technetium uptake. In 8 of these cases, clinical onset in late childhood, high frequency of antithyroid antibodies and of familial thyroid dysfunction were similar to those found in childhood's thyroiditis. 8 other cases had a precocious onset (first months in 6, first year in 1, second year in 1) with some pretracheal iodine uptake when first studied and no uptake at further examinations, 1 patient having received no treatment from first to second study, the others being without treatment from more than two months and certain of them receiving injections of TSH. The last 5 cases of this group were those of children born to 2 mothers with treated hypothyroidism, with low iodine uptake in pretracheal place. The role of genetic factors and auto-immunity in theses cases is discussed. The 6 other patients had clinically isolated hypothyroidism secondary to TSH deficiency, eventually associated to clinically inapparent GH or ACTH deficiencies, most of them by hypothalamic defect with normal response to TRH.
对27例甲状腺功能减退的婴幼儿进行了研究,尽管甲状腺或甲状腺组织位于气管前正常位置,但碘摄取率较低。21例与原发性甲状腺受累有关,导致碘或锝摄取消失。在其中8例中,儿童晚期的临床起病、抗甲状腺抗体的高频率以及家族性甲状腺功能障碍与儿童甲状腺炎中发现的情况相似。另外8例起病较早(6例在最初几个月,1例在第一年,1例在第二年),首次研究时气管前有一些碘摄取,进一步检查时无摄取,1例患者从首次研究到第二次研究未接受治疗,其他患者超过两个月未接受治疗,其中一些人接受了促甲状腺激素注射。该组的最后5例是2名患有甲状腺功能减退症并接受治疗的母亲所生的儿童,气管前碘摄取率较低。讨论了这些病例中遗传因素和自身免疫的作用。另外6例患者临床上为促甲状腺激素缺乏继发的单纯性甲状腺功能减退,最终可能与临床上不明显的生长激素或促肾上腺皮质激素缺乏有关,其中大多数是下丘脑缺陷,对促甲状腺激素释放激素反应正常。