Çocukluk Çağı Hashimoto Tiroiditi Tanılı Olguların Klinik Özellikleri ve İzlem Bulguları-Retrospektif Tek Merkez Deneyimi

Yıl 2019, Cilt: 11 Sayı: 1, 89 - 94, 25.03.2019

Özlem Korkmaz Samim Özen Damla Gökşen Şükran Darcan

https://doi.org/10.18521/ktd.432200

Cited By: 1

Öz

Amaç: Çocuk ve ergenlerde Hashimoto tiroditi tanılı olguların başvuru ve izlem klinik ve laboratuvar özelliklerinin belirlenmesidir.

Gereç- Yöntem: Kliniğimizde Hashimoto Tiroiditi tanısıyla izlenen 83 olgunun başvuru izlemlerindeki klinik özellikleri, tiroid fonksiyon testleri, tiroid otoantikorları, ilaç tedavileri retrospektif olarak değerlendirildi.

Bulgular: Tanı anında ortalama yaş 11.3 ± 3.0 yaş olarak saptandı. Olguların %51.8’nin ailesinde tiroid hastalığı öyküsü alındı. Kız erkek oranı: 3.3/1 idi. Çalışma grubunun ağırlık standart deviasyon skoru (SDS) : 0.3 ± 1.3, boy SDS: 0.3 ± 2.8 olarak bulundu. Olguların %34.9’u rastlantısal, %27.7’si de guatr yakınması ile başvurdu. Fizik bakıda %68.7 oranında guatr saptandı. Tiroid fonksiyon testlerine göre başvuru sırasında ötiroidi %46.8, subklinik hipotiroidi %33.7, hipotiroidi %17.7, aşikar hipertiroidi %2.5, subklinik hipertiroidi %2.5 oranında bulundu. L-tiroksin tedavisi başlanılan grubun anti-TPO ve anti-Tg antikor düzeyleri tedavi başlanmayan olgulara kıyasla daha yüksek saptandı (p=0.01,p=0.051). Başlangıçta ötiroid olup ilaç başlanmayan 37 hastanın 13’üne (%35.1) izlemde sub-klinik ya da açık hipotiroidi geliştiği için L-tiroksin başlandı.

Sonuç: Hashimato Tiroiditi tanısıyla izlenen çocukluk çağı olguları başlangıçta ötiroid olsalar bile izlemde önemli bir kısmında hipotiroidi gelişebileceğinden düzenli aralıklarla tiroid fonksiyon testleri ile izlenmelidir.

Anahtar Kelimeler

hashimoto tiroiditi, guatr, çocuk

Clinical Charecteristics and Follow- up Findings of the Cases Pediatric Hashimoto’ Thyroiditis- Retrospective a Single Centre Experience

Öz

Objective:
The aim of this study was to evaluate the clinical and laboratory
characteristics at presentation  and
follow-up period of patients with Hashimoto  thyroiditis in children and adolescents.

Methods:
The clinical features, thyroid function tests, thyroid autoantibodies, tyhroid
ultrasound data and drug treatments of 83 patients with Hashimoto  thyroiditis at diagnosis and follow-up period
were retrospectively evaluated.

Results:
The mean age of the patients at the time of diagnosis was 11.3 ± 3.0 years .
The male to female ratio was 3.3 / 1. 51.8% of patients had a family history of
thyroid disease. The complaint at the time of presentation was goiter in 27.7 %
of the patients and 34.9% of the cases were coincidental determination. At
physical examination, 68.7% of goiter of the patients were found. According to
the thyroid function tests, 46.8% of the patients had euthyroidism, 33.7% of
subclinical hypothyroidism, 17.7% of hypothyroidism, 2.5% of hyperthyroidism
and 2.5% of subclinical hyperthyroidism. Anti-TPO and anti-Tg antibody levels
of the group in which L-thyroxine treatment was started were found to be higher
than those in the untreated patients (p = 0.01 and p = 0.051, respectively).
L-thyroxine was initiated in 13 (35.1%) of the 37 patients who were initially
euthyroid and did not receiving treatment at presentation because of
subclinical or clear hypothyroidism was observed of the follow-up.

Conclusion:
Thyroid functions of the pediatric patients with Hashimoto  thyroiditis should be follow up regular
intervals, even if they are initially euthyroid, since hypothyroidism may
develop in a significant cases of the follow-up period.

Anahtar Kelimeler

hashimoto thyroiditis, goiter, child

Kaynakça

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