Hashimoto Tiroidili Çocuk ve Adolesanların Tanı Anındaki ve İzlemdeki Klinik ve Laboratuvar Özellikleri

Amaç: Hashimoto tiroiditi (HT) tanısı ile izlenen çocuk ve adolesanların tanı anındaki ve izlemdeki klinik ve laboratuvar bulgularının değerlendirilmesiamaçlandı.Gereç ve Yöntem: Çocuk endokrinoloji kliniğinde Ocak 2015-Ocak 2019 tarihleri arasında HT tanısı ile takip edilen, yaşları 4-18 yıl arasında değişentoplam 181 hasta çalışmaya alındı. Tüm hastaların tanı anında ve izlemdeki oksolojik, klinik, laboratuvar ve radyolojik verileri dosya kayıtlarındandeğerlendirildi.Bulgular: Tüm hastaların %85’i kızdı. Hastaların yaş ortalaması 13,4±3,2 yıldı ve %77’si pubertaldi. Hastaların takip süreleri 22,5±10,3 ay (4-54 ay)idi. Tanı sırasında tiroid fonksiyonuna göre %35’inde ötiroidi, %29’unda subklinik hipotiroidi, %22’sinde hipotiroidi, %4’ünde subklinik hipertiroidive %10’unda hipertiroidi saptandı. Hastaların en sık başvuru şikayetleri arasında halsizlik (%44), saç dökülmesi (%25), kabızlık (%23) ve boyundaşişlik (%21) geliyordu. Hastaların başvurudaki USG görüntülemede %13’ünde nodül saptandı. Ötiroidili hastalarda nodül sıklığı fazlayken, boyutartışı hipertiroidili olgularda daha fazla saptandı. İzlemde hastaların %6’sında izlemde nodül gelişimi gözlendi. Subklinik hipertiroidili hastalarınhepsi izlemde ötiroid oldu. Ötiroidili hastaların ise %13’ünde hipotiroidi geliştiği gözlendi. En sık eşlik eden hastalıklar polikistik over sendromu vevitiligo idi.Sonuç: HT’li hastaların geliş şekilleri oldukça değişken olup, izlemde de klinik değişiklikler devam etmektedir. Bu nedenle bu hastaların tanıdanitibaren yakın takip edilmesi ve ilişkili diğer hastalıklar açısından dikkat edilmesi önemlidir.

Clinical and Laboratory Characteristics of Children and Adolescents with Hashimoto Thyroiditis at Diagnosis and During Follow-up

Objectives: The aim of this study was to evaluate the clinical and laboratory findings of children and adolescents with Hashimoto thyroiditis (HT) at diagnosis and during follow-up. Materials and Methods: Between January 2015 and January 2019, a total of 181 patients aged between 4 and 18 years who were followed in the pediatric endocrinology department were evaluated. All patients were evaluated at the time of diagnosis and during follow-up with the clinical, laboratory and radiological data. Results: Female patients constituted 85% of all patients. Mean age at diagnosis was 13.4±3.2 years and 77% of patients were pubertal. The followup period was 22.5±10.3 months (4-54 months). At the time of diagnosis 35% of patients were euthyroid, 29% had subclinical hypothyroidism, 22% had overt hypothyroidism, 4% had subclinical hyperthyroidism and 10% had overt hyperthyroidism. The common complaints of the patients were fatigue (44%), hair loss (25%), constipation (23%) and goitre (21%). In the ultrasonographic imaging of the patients, nodule was detected in 13% of the patients. The frequency of nodules was higher in patients with euthyroidism. Increased size of the thyroid gland was common in patients with hyperthyroidism. In follow-up, nodule development was observed in 6% of patients. All patients with subclinical hyperthyroidism became euthyroid during follow-up. Hypothyroidism developed in 13% of euthyroid patients during follow-up. The most common concomitant diseases were polycystic ovary syndrome and vitiligo.Conclusion: The admission of patients with HT is highly variable and clinical changes have continued during follow-up. Therefore these patients should be followed closely from the diagnosis and attention should be paid to other related diseases

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