Rahime Gül MUTLU YEŞİLTEPE, Elif ÖZSU, Şükrü HATUN, Filiz ÇİZMECİ

Hashimoto tiroiditli hastalarımızın özellikleri

Amaç: Hashimoto tiroiditi (HT) çocuk ve ergenlerdeki guatrın ve edinsel hipotiroidin en sık sebebidir. Bu çalışmada HT ile başvuran hastalarımızın klinik, epidemiyolojik ve laboratuvar bulgularını sunmayı amaçladık. Gereç ve Yöntem: Kliniğimizde Ocak 2004- Aralık 2009 yılları arasında takip edilen 106 hasta değerlendirildi. Hastalar tiroid işlevlerine göre dört gruba ayrıldı. Bulgular: Tüm hastaların %78’i kız olup, HT kızlarda 3,6 kat daha fazla saptandı. Ortalama tanı yaşı 11,5±2,8 yıl idi. Tanı anında hastalarımızın %42,5’i ötiroid, %24,5’i subklinik hipotiroidizm, %29’u aşikar hipotiroidizm ve %2,8’i subklinik hipertiroidizm tablosunda idi. En sık başvuru şikayeti %46 ile guatr iken, %26’sında gelişme geriliği, %13’ünde kilo alımı, %6,6 kilo kaybı, %5,5’inde ise sinirlilik idi. Aile öyküsü olguların %36’sında mevcut olup, %26,4’ünde ise başka bir otoimmün hastalık saptandı. En sık eşlik eden otoimmün hastalık tip 1 Diyabetes Mellitus (DM) idi. İki olguda da çölyak , tip 1 DM ve HT birlikte izlendi. Vitiligo bir hastada saptandı. Çıkarımlar: Otoimmün hastalıklarda artmış sıklığı nedeni ile HT, olgularda belli aralıklarla araştırılmalıdır. (Türk Ped Arfl 2011; 46: 252-5)

Characteristics of our patients with hashimoto thyroiditis

Aim: Hashimoto’s thyroiditis (HT) is the most common cause of goiter and acquired hypothyroidism in children and adolescents. We aimed to investigate the clinical manifestations, epidemiological and laboratory characteristics of the patients with HT. Material and Methods: We reviewed files of 106 children and adolescents with HT followed in the Department of Pediatric Endocrinology, between january 2004 and december 2009. The patients were classified in to four groups with respect to their thyroid functions. Results: Female patients constituted 78% (n=83) of all patients. Hashimoto’s thyroiditis was 3.6 times more common in females. Mean age at diagnosis was 11.5±2.8 years. At the time of diagnosis 42.5% of patients (n:45) were euthyroid, 24.5% (n:26) had subclinical hypothyroidism, 29% (n:31) had overt hypothyroidism and 2.8% (n:3) had subclinical hyperthyroidism. The common complaints leading to referral were goitre in 49 (46%) children. Twenty six percent of all patients were admitted with growth retardation, 13% with weight gain 6,4% with weight loss, and 5.5% with nervousness. Family history for thyroid disease was positive in 38 (35.8%) children. There were 28 patients (26.4%) in whom the disease was associated with some other autoimmune diseases. The most common concomitant autoimmune disease was type 1 diabetes mellitus (DM) (21.7%). Two patients (1,9%) had both type 1 diabetes mellitus and celiac disease and one patient (1%) had vitiligo. Conclusions: We must test for HT in autoimmune disease patients periodically because of increased risk. (Turk Arch Ped 2011; 46: 252-5)

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