Year 2019, Volume 11, Issue 1, Pages 89 - 94 2019-03-25

Clinical Charecteristics and Follow- up Findings of the Cases Pediatric Hashimoto’ Thyroiditis- Retrospective a Single Centre Experience
Çocukluk Çağı Hashimoto Tiroiditi Tanılı Olguların Klinik Özellikleri ve İzlem Bulguları-Retrospektif Tek Merkez Deneyimi

Özlem Korkmaz [1] , Samim Özen [2] , Damla Gökşen [3] , Şükran Darcan [4]

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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.

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.

  • Referans1.Wasniewska M, Vigone MC, Cappa M, et al. Study Group for Thyroid diseases of Italian Society for Pediatric Endocrinology: Acute suppurative thyroiditis in childhood: relative frequency among thyroid inflammatory diseases. J Endocrinol Invest 2007;30(4):346–7.
  • Referans2. Radetti G: Clinical aspects of Hashimoto’s thyroiditis. Endocr Dev 2014;26:158–70.
  • Referans3.Radetti G, Gottardi E, Bona G, et al. The natural history of euthyroid Hashimoto's thyroiditis in children. J Pediatr 2006;149(6): 827-32.
  • Referans4. Lorini R, Gastaldi R, Traggiai C, Perucchin PP. Hashimoto's thyroiditis. Pediatr Endocrinol Rev 2003;1: 205-11.
  • Referans5. Lazar L, Frumkin RB, Battat E, Lebenthal Y, Phillip M & Meyerovitch J. Natural history of thyroid function tests over 5 years in a large pediatric cohort. Journal of Clinical Endocrinology and Metabolism 2009;94:1678–82.
  • Referans6. Zadik Z. Overuse or misuse of thyroid function tests in pediatrics. Journal of Pediatric Endocrinology & Metabolism 2009;22(10): 875–6.
  • Referans7. Amino N, Tada H, Hidaka Y. Chronic (Hashimoto's) thyroiditis. In: DeGroot LJ, Jameson JL (eds). Endocrinology. 4th ed. Philadelphia, PA: WB Saunders;2001.p.1471– 80.
  • Referans8. Vanderpump MPJ, Tunbridge WMG, French JM, et al. The incidence of thyroid disorders in the community: a twenty year followup of the Whickham survey. Clin Endocrinol 1995;43(1):55–68.
  • Referans9. Gordin A, Lamberg BA. Spontaneous hypothyroidism in symptomless autoimmune thyroiditis: a long-term followup study. Clin Endocrinol 1981;15(6):537–43.
  • Referans10. Marshall WA, Tanner JM. Variations in the pattern of pubertal changes in girls. Arch Dis Child. 1969;44(235):291–303.
  • Referans11. Bundak R, Furman A, Gunoz H, Darendeliler F, Bas F, Neyzi O. Body mass index references for Turkish children. Acta Paediatr 2006;95(2):194-8.
  • Referans12. Neyzi O, Furman A, Bundak R, Gunoz H, Darendeliler F, Bas F. Growth references for Turkish children aged 6 to 18 years.Acta Paediatr 2006;95(12):1635-41.
  • Referans13. Delange F, Benker G, Caron P, et al. Thyroid volume and urinary iodine in European schoolchildren: standardization of values for assessment of iodine deficiency. Eur J Endocrinol. 1997;136(2):180–7.
  • Referans14. WHO. Recommended normative values for thyroid volume in children aged 6-15 years. World Health Organization & International Council for Control of Iodine Deficiency Disorders. Bull World Health Organ. 1997;75:95–7.
  • Referans15. Gopalakrishnan S, Chugh PK, Chhillar M, Ambardar VK, Sahoo M, Sankar R. Goitrous autoimmune thyroiditis in a pediatric population: a longitudinal study. Pediatrics. 2008;122(3):670–74.
  • Referans16. Desai MP, Karandikar S. Autoimmune thyroid disease in childhood: a study of children and their families. Indian Pediatr.1999;36(7):659–68.
  • Referans17. Demirbilek H, Kandemir N, Gonc EN, Ozon A, Alikaşifoğlu A, Yordam N. Hashimoto’s thyroiditis in children and adolescents: a retrospective study on clinical, epidemiological and laboratory properties of the disease. J Pediatr Endocrinol Metab 2007;20(11):199-205.
  • Referans18. Dilek E, İşcan B, Ekuklu G, Tütüncüler F. Hashimoto tiroiditi tanısı alan vakaların geriye dönük değerlendirilmesi.Çocuk Dergisi 2011;11(2):73-7.
  • Referans19. Setian NS. Hypothyroidism in children: diagnosis and treatment. J Pediatr 2007; 83(5):209-16.
  • Referans20. Marković S, Kostić G, Igrutinović Z, Vuletić B. Hashimoto's thyroiditis in children and adolescents. Srp Arh Celok Lek 2008; 136(5-6): 262-6.
  • Referans21. Yeşilkaya E, Belen B, Bideci A, Çamurdan O, Boyraz M, Cinaz P. Kronik otoimmün tiroiditli çocuk ve ergenlerin klinik özellikleri. Gülhane Tıp Dergisi 2008; 50: 147-50.
  • Referans22. Cappa M, Bizzarri C, Crea F. Autoimmune thyroid diseases in children. J Thyroid Res, 2011;675-703.
  • Referans23. Caturegli P; De Remigis A; Rose NR. Hashimoto thyroiditis: clinical and diagnostic criteria. Autoimmun Rev 2014;13(4-5): 391-7.
  • Referans24. Giorgio Radetti. Clinical Aspects of Hashimoto’s Thyroiditis. Paediatric Thyroidology. Endocr Dev. Basel 2014; 26:158–70.
  • Referans25. Romaldini JH, Biancalana MM, Figueiredo DI, Farah CS, Mathias PC. Effect of L-thyroxine administration on antithyroid antibody levels, lipid profile, and thyroid volume in patients with Hashimoto's thyroiditis. Thyroid 1996;6(3):183–8.
  • Referans26. Svensson J, Ericsson UB, Nilsson P, Olsson C, Jonsson B, Lindberg B, Ivarsson SA. Levothyroxine treatment reduces thyroid size in children and adolescents with chronic autoimmune thyroiditis. J Clin Endocrinol Metab. 2006;91(5):1729–34.
  • Referans27. Vanderpump MP, French JM, Appleton D, Tunbridge WM, Kendall-Taylor P. The prevalence of hyperprolactinaemia and association with markers of autoimmune thyroid disease in survivors of the Whickham Survey cohort. Clin Endocrinol (Oxf) 1998;48(1):39–44.
  • Referans28. Wang C, Crapo LM. The epidemiology of thyroid disease and implications for screening. Endocrinol Metab Clin North Am 1997;26(1):189–218.
  • Referans29. Vanderpump MP, Tunbridge WM. Epidemiology and prevention of clinical and subclinical hypothyroidism. Thyroid 2002;12(10):839–47.
  • Referans30. Wasniewska M, Corrias A, Salerno M, et al. Thyroid Function Patterns at Hashimoto's Thyroiditis Presentation in Childhood and Adolescence Are Mainly Conditioned by Patients' Age. Horm Res Paediatr 2012;78(4):232–236.
  • Referans31. Sklar CA, Qazi R, David R. Juvenile autoimmune thyroiditis. Am J Dis Child 1986;140(9):877– 880.
  • Referans32. Wasniewska M, Corrias A, Salerno M, et al. Outcomes of children with hashitoxicosis. Horm Res Paediatr. 2012;77(1):36–40.
  • Referans33. Yoshida H, Amino N, Yagawa K, et al. Association of serum antithyroid antibodies with lymphocytic infiltration of the thyroid gland: studies of seventy autopsied cases. J Clin Endocrinol Metab 1978;46(6):859–62.
  • Referans34. Mariotti S, Caturegli P, Piccolo P, Barbesino G, Pinchera A. Antithyroid peroxidase autoantibodies in thyroid diseases. J Clin Endocrinol Metab. 1990;71(3):661–9.
  • Referans35. Padberg S, Heller K, Usadel KH, Schumm-Draeger PM. One-year prophylactic treatment of euthyroid Hashimoto's thyroiditis patients with levothyroxine: is there a benefit? Thyroid. 2001;11(3):249–55.
Primary Language tr
Subjects Health Care Sciences and Services
Published Date Mart 2019
Journal Section Articles
Authors

Author: Özlem Korkmaz (Primary Author)
Institution: Ege Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı, Çocuk Endokrinoloji Bilim Dalı, İzmir
Country: Turkey


Author: Samim Özen
Institution: Ege Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı, Çocuk Endokrinoloji Bilim Dalı, İzmir

Author: Damla Gökşen
Institution: Ege Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı, Çocuk Endokrinoloji Bilim Dalı, İzmir

Author: Şükran Darcan
Institution: Ege Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı, Çocuk Endokrinoloji Bilim Dalı, İzmir

Bibtex @research article { ktd432200, journal = {Konuralp Medical Journal}, issn = {1309-3878}, eissn = {1309-3878}, address = {Duzce University}, year = {2019}, volume = {11}, pages = {89 - 94}, doi = {10.18521/ktd.432200}, title = {Çocukluk Çağı Hashimoto Tiroiditi Tanılı Olguların Klinik Özellikleri ve İzlem Bulguları-Retrospektif Tek Merkez Deneyimi}, key = {cite}, author = {Korkmaz, Özlem and Özen, Samim and Gökşen, Damla and Darcan, Şükran} }
APA Korkmaz, Ö , Özen, S , Gökşen, D , Darcan, Ş . (2019). Çocukluk Çağı Hashimoto Tiroiditi Tanılı Olguların Klinik Özellikleri ve İzlem Bulguları-Retrospektif Tek Merkez Deneyimi. Konuralp Medical Journal, 11 (1), 89-94. DOI: 10.18521/ktd.432200
MLA Korkmaz, Ö , Özen, S , Gökşen, D , Darcan, Ş . "Çocukluk Çağı Hashimoto Tiroiditi Tanılı Olguların Klinik Özellikleri ve İzlem Bulguları-Retrospektif Tek Merkez Deneyimi". Konuralp Medical Journal 11 (2019): 89-94 <http://dergipark.org.tr/ktd/issue/44366/432200>
Chicago Korkmaz, Ö , Özen, S , Gökşen, D , Darcan, Ş . "Çocukluk Çağı Hashimoto Tiroiditi Tanılı Olguların Klinik Özellikleri ve İzlem Bulguları-Retrospektif Tek Merkez Deneyimi". Konuralp Medical Journal 11 (2019): 89-94
RIS TY - JOUR T1 - Çocukluk Çağı Hashimoto Tiroiditi Tanılı Olguların Klinik Özellikleri ve İzlem Bulguları-Retrospektif Tek Merkez Deneyimi AU - Özlem Korkmaz , Samim Özen , Damla Gökşen , Şükran Darcan Y1 - 2019 PY - 2019 N1 - doi: 10.18521/ktd.432200 DO - 10.18521/ktd.432200 T2 - Konuralp Medical Journal JF - Journal JO - JOR SP - 89 EP - 94 VL - 11 IS - 1 SN - 1309-3878-1309-3878 M3 - doi: 10.18521/ktd.432200 UR - https://doi.org/10.18521/ktd.432200 Y2 - 2019 ER -
EndNote %0 Konuralp Medical Journal Çocukluk Çağı Hashimoto Tiroiditi Tanılı Olguların Klinik Özellikleri ve İzlem Bulguları-Retrospektif Tek Merkez Deneyimi %A Özlem Korkmaz , Samim Özen , Damla Gökşen , Şükran Darcan %T Çocukluk Çağı Hashimoto Tiroiditi Tanılı Olguların Klinik Özellikleri ve İzlem Bulguları-Retrospektif Tek Merkez Deneyimi %D 2019 %J Konuralp Medical Journal %P 1309-3878-1309-3878 %V 11 %N 1 %R doi: 10.18521/ktd.432200 %U 10.18521/ktd.432200
ISNAD Korkmaz, Özlem , Özen, Samim , Gökşen, Damla , Darcan, Şükran . "Çocukluk Çağı Hashimoto Tiroiditi Tanılı Olguların Klinik Özellikleri ve İzlem Bulguları-Retrospektif Tek Merkez Deneyimi". Konuralp Medical Journal 11 / 1 (March 2019): 89-94. https://doi.org/10.18521/ktd.432200