Çocukluk Çağı Hashimoto Tiroiditi Tanılı Olguların Klinik Özellikleri ve İzlem Bulguları-Retrospektif Tek Merkez Deneyimi
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Tarih
2019
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Çocuk ve ergenlerde Hashimoto tiroditi tanılı olguların başvuru ve izlemdeki klinik ve laboratuvar özelliklerinin belirlenmesidir. Gereç ve Yöntem: Kliniğimizde Hashimoto tiroiditi tanısıyla izlenen 83 olgunun başvuru ve izlemlerindeki klinik özellikleri, tiroid fonksiyon testleri, tiroid otoantikorları, ilaç tedavileri geriye dönük 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: 0.4 ± 2.8, vücut kitle indeksi SDS: 0.4±1.2 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, 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 subklinik ya da aşikar 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.
Objective: the aim of this study was to evaluate the clinical and laboratory characteristics at application and during progression of Hashimoto's thyroiditis at children and adolescents. Methods: the clinical characteristics, thyroid function tests, thyroid autoantibodies, thyroid ultrasound datas and drug treatments of 83 patients with Hashimoto's thyroiditis were retrospectively evaluated. Results: Patients’ mean age at time of diagnosis were determinated 11.3 ± 3.0 years. the male to female ratio was 3.3:1, and 51.8% of patients had a family history of thyroid disease. Mean weight SDS was 0.3 ± 1.3, mean height SDS was 0.4 ± 2.8 and mean body mass index SDS was 0.4±1.2. the principal symptom at time of gripe was goiter, in 27.7% of patients, and 34.9% of cases were identified incidentally. At physical examination, goiter was determined in 68.7% of patients. According to the thyroid function test results, 46.8% of patients had euthyroidism, 33.7% subclinical hypothyroidism, 17.7% hypothyroidism, 2.5% hyperthyroidism and 2.5% subclinical hyperthyroidism. Anti-TPO and anti-Tg antibody levels of the group started on L-thyroxine therapy were 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 not receiving treatment at presentation, due to subclinical or over hypothyroidism being observed at follow-up. Conclusion: Thyroid functions of pediatric patients with Hashimoto's thyroiditis should be followed up at regular intervals, even if they are initially euthyroid, since hypothyroidism may develop in a significant number of cases in the follow-up period.
Objective: the aim of this study was to evaluate the clinical and laboratory characteristics at application and during progression of Hashimoto's thyroiditis at children and adolescents. Methods: the clinical characteristics, thyroid function tests, thyroid autoantibodies, thyroid ultrasound datas and drug treatments of 83 patients with Hashimoto's thyroiditis were retrospectively evaluated. Results: Patients’ mean age at time of diagnosis were determinated 11.3 ± 3.0 years. the male to female ratio was 3.3:1, and 51.8% of patients had a family history of thyroid disease. Mean weight SDS was 0.3 ± 1.3, mean height SDS was 0.4 ± 2.8 and mean body mass index SDS was 0.4±1.2. the principal symptom at time of gripe was goiter, in 27.7% of patients, and 34.9% of cases were identified incidentally. At physical examination, goiter was determined in 68.7% of patients. According to the thyroid function test results, 46.8% of patients had euthyroidism, 33.7% subclinical hypothyroidism, 17.7% hypothyroidism, 2.5% hyperthyroidism and 2.5% subclinical hyperthyroidism. Anti-TPO and anti-Tg antibody levels of the group started on L-thyroxine therapy were 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 not receiving treatment at presentation, due to subclinical or over hypothyroidism being observed at follow-up. Conclusion: Thyroid functions of pediatric patients with Hashimoto's thyroiditis should be followed up at regular intervals, even if they are initially euthyroid, since hypothyroidism may develop in a significant number of cases in the follow-up period.
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