Semih BOLU, Fatih İŞLEYEN, Mehmet TURGUT

The etiological distribution and clinical and laboratory characteristics of pediatric patients presenting with goiter in the province of Adıyaman

Aim: The most common cause of goiter in developed countries is autoimmune diseases, while the most common cause in developing countries is iodine deficiency. We aimed to evaluate the clinical and laboratory results and etiological and demographic characteristics of cases presenting with goiter. Materials and Methods: Seventy-five patients aged between 5 and 17 years presenting with goiter between October 2016 and January 2019 were included in the study. Results: 90.7% (68) of children with goiter were female and 9.3% (7) male, the rate of goiter being 9.7-fold higher among girls. In terms of etiology, 43 patients (57.3%) were diagnosed with iodine deficiency, 25 (33.3%) with Hashimoto’s thyroiditis (HT), five with Graves’ disease (6.7%), and two (2.7%) with thyroid hormone resistance (THR). Mean ages were 13.7±2.1 years in the iodine deficient cases, 13.7±2.7 in the HT group, 14.3±1.4 in the Graves’ disease patients, and 8.2±2.3 in the patients with THR. The highest mean urinary iodine level among iodine deficient patients was 45±27.1 (12.10- 84.13) μg/L in Adıyaman center, while the lowest value was determined in Gerger district at 16.8±3.1 (14.27-20.25) μg/L, and 11 patients were diagnosed with mild iodine deficiency, 20 with moderate deficiency, and 12 with severe deficiency. Conclusion: Iodine deficiency was the most common cause of goiter in children in the province of Adıyaman, followed by autoimmune thyroid gland diseases such as Graves’ disease and HT. This study shows that iodine deficiency remains still as a problem in our province.

Adıyaman ilinde guatrla başvuran çocuk hastalarda etiyolojik dağılım ile klinik ve laboratuvar özellikler

Amaç: Gelişmiş ülkelerde guatrın en sık sebebi otoimmün hastalıklar iken gelişmekte olan ülkelerde en yaygın neden iyot eksikliğidir. Guatr ile başvuran olguların klinik ve laboratuvar sonuçları ile etiyolojik ve demografik özelliklerini değerlendirmeyi amaçladık. Gereç ve Yöntem: Çalışmaya Ekim 2016 ile Ocak 2019 tarihleri arasında guatr ile başvuran 5-17 yaş arasındaki 75 hasta dahil edildi. Bulgular: Guatrlı çocukların % 90,7'si (68) kız, % 9,3'ü (7) erkek idi ve guatr oranı kızlarda 9,7 kat daha yüksek bulundu. Etiyoloji açısından 43 hastaya (% 57,3) iyot eksikliği, 25 hastaya (% 33,3) Hashimoto tiroiditi (HT), 5 hastaya Graves hastalığı (% 6,7) ve 2 hastaya (% 2,7) Tiroid hormon direnci (THD) tanısı konuldu. İyot eksikliği olan olgularda ortalama yaş 13,7 ± 2,1 yıl, HT grubunda 13,7 ± 2,7 yıl, Graves hastalarında 14,3 ± 1,4 yıl ve THD'li hastalarda 8,2 ± 2,3 yıl idi. İyot eksikliği olan hastalarda ortalama idrar iyot düzeyi en yüksek Adıyaman merkezde 45 ± 27,1 (12,10-84,13) μg/L olarak saptanırken, en düşük değer Gerger bölgesinde 16,8 ± 3,1 (14,27-20,25) μg/L idi. Sonuç: İyot eksikliği Adıyaman ilindeki çocuklarda guatrın en sık sebebi olup bunu Graves hastalığı ve HT gibi otoimmün tiroid bezi hastalıkları izliyordu. Bu çalışma iyot eksikliğinin ilimiz genelinde yaygın bir sorun olarak devam ettiğini göstermektedir.

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