Aim: To study the etiology and the treatment of the non endemic goiter, in our region.
Material and methods: The study group consisted of 67 children (F/M: 48/19; age: 417 years old) with non endemic goiter admitted in our hospital during the period, 20032008. The diagnostic procedures were represented by: the clinical examination (including the anthropometric measures and pubertal stages after Tanners criteria), laboratory data (serum cholesterol, triglycerides, urinary iodine), the thyroid function tests (TSH, freeT4, free T3), immunologic parameters (antiTPO and antithyroglobulin antibodies); thyroid ultrasonography (thyroid volume and aspect). The bone age and thyroid MRI were performed in selected cases. All the cases were followed over 36 month under treatment.
Results and discussions: According to the thyroid functional tests, the patients were divided in four groups. Group I: 28 euthyroid patients were treated with iodine and after 1 year the goiter disappeared in 25 patients (89.25%). Group II: 22 hypothyroid patients, (20 with chronic autoimmune thyroiditis (CAT) and 2 cases of dishormonogenesis). All the cases were treated with L-Thyroxin. The goiter decreased after 1 year, especially in the CAT cases. Group III: 9 patients with elevated serum TSH level (subclinical hypothiroism); only the children with high levels of the serum cholesterol were treated with L-Thyroxin. Group IV: 4 cases with autoimmune hyperthyroidism were treated, initially, with thiamazol and, subsequently, the children developed hypothyroidism and were treated, with L-Thyroxin.
Conclusions: 1. The goiter in childhood may have variable causes;In our region head especialy an autoimmune etiology.
2. The treatment depends on the etiology and thyroid function.
25 - 29 Apr 2009
European Society of Endocrinology