Endocrine Abstracts

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 Tanner’s 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: 2–17 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.