Bumin DÜNDAR, Özlem SANGÜN, Nihal DÜNDAR, Aslıhan BOYACI

Çocuk ve ergenlerde Hashimoto tiroiditi: Klinik ve laboratuvar bulgularının değerlendirilmesi

Amaç: Hashimoto tiroiditi (HT) tanısı ile izlenen çocuk ve ergenlerin klinik ve laboratuvar bulgularının geriye dönük olarak değerlendirilmesi. Gereç ve Yöntem: Hashimoto tiroiditi tanısı almış, yaşları 4-17 yıl arasında değişen toplam 78 hasta, çalışmaya alındı. Tüm olguların tanı ve izlemdeki tiroid işlev testleri, tiroid peroksidaz antikorları (anti-TPO), tiroid ultrasonografileri, fizik muayene bulguları ve aile öyküleri değerlendirildi. Bulgular: Tanı sırasında iki (%2,6) olguda hipertiroidi saptanırken, 10’unda (%11,7) hipotiroidi, 17’sinde (%21,8) subklinik hipotiroidi, 49’unda (%62,8) ise ötiroidi tablosu vardı. En sık karşılaşılan klinik bulguların sinirlilik, aşırı terleme, kilo artışı ve iştahsızlık olduğu görüldü. Tanı anında 63 olguda (%80,8) guatr, 52 olguda (%66,7) anti-TPO pozitifliği saptandı. Ötiroid olan 19 olgunun izleminde iki hastada hipertirodi, birinde hipotiroidi ve birinde subklinik hipotiroidi geliştiği gözlendi. Olguların 31’inin (%39) ailelerinde HT veya tiroid hastalığı öyküsü vardı. Çıkarımlar: Hashimoto tiroiditli çocuk ve ergen olgularda tanı ve izlem sırasında klinik ve laboratuvar bulguları değişkenlik gösterebilmektedir. Olguların yakın izlemi önemlidir.

Hashimoto thyroiditis in children and adolescents: Evaluation of clinical and laboratory findings

Aim: The objective of this study was retrospective analyses of clinical and laboratory findings of children and adolescents with Hashimoto thyroiditis. Material and Method: We evaluated 78 patients with HT who were between 4-17 years of age. Physical examination and family history of the patients, thyroid functions, auto-antibody titers and USG scans were evaluated retrospectively. Results: Two (2.6%) patients presented with hyperthyroidism, while 10 (11.7%), 17 (21.8%) and 49 (62.8%) patients with hypothyroidism, subclinical hypothyroidism and euthyroidism, respectively. The major symptoms were nervousness, sweating, weight gain and loss of appetite. Sixty-three (80.8%) patients had goiter and 52 (66.7%) patients had positive anti-thyroid peroxidase antibody at diagnosis. Among the 19 patients who were eutyroid initially two patients became hyperthyroid, one became hypothyroid and one became subclinical hypothyroid during follow-up. Family history for thyroid disease was determined in 31 (39%) patients. Conclusions: Clinical and laboratory findings may vary at diagnosis and during follow-up in children and adolescents with HT. Periodic monitoring of the patients is very important.

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