Aim: To show the etiology of thyromegaly in our region to asses the rationale treatment and follow up.
Material and methods: Between 2005 and 2010, we have studied the prevalence and etiologic profile of the children with thyromegaly admitted in the Endocrinology Department of our hospital. The working protocol included: weight and length birth, gestational age, auxological parameters and pubertal stages after Tanners criteria, morphogram, laboratory studies (usual BCC, serum cholesterol, triglycerides, urinary iodine, the thyroid function tests (TSH, free T4, free T3), immunologic parameters (antiTPO and antithyroglobulin antibodies)); thyroid ultrasound (thyroid volume and aspect). The bone age, thyroid MRI and iodine uptake were performed in selected cases. All the cases were followed at last 3 years under treatment.
Results: The study a group consisted of 72 children (F/M: 51/21; age: 217 years). According to the clinical exam, thyroid tests, imagistic exams the patients were divided in four groups. Group A: 36 patients euthyroid diffuse thyromegaly, treated with iodine and after 1 year the goiter disappeared in 27 patients (75%). Group B: 27 hypothyroid patients, (25 with chronic autoimmune thyroiditis 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 C: 4 cases with autoimmune hyperthyroidism treated, initially, with thiamazol. Group D: 5 patients with thyroidian nodule/chist who follow chirurgical intervention, 3 of them had subclinical hypothiroism after intervention; in this group only the children with high levels of the serum cholesterol were treated with L-thyroxin; 2 cases no needed substitute therapy after 2 years of follow up.
Conclusions: 1. In our region the etiologic profile is quite various. 2. The treatment depends on the etiology and thyroid function. 3. The response of the treatment in childhood is satisfied.
30 Apr - 04 May 2011
European Society of Endocrinology