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

Abstract

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.

Keywords

• hashimoto tiroiditi,guatr,çocuk

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

Abstract

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.

Keywords

• hashimoto thyroiditis,goiter,child

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