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Ultrasonographic assessment of thyroid volume in Delhi children
Dinkar Bakshi1, A Seth, M K Narula
1Department of Paediatrics, Lady Hardinge Medical College, Delhi, India. dinkarbakshi@rediffmail.com
Insights
Ultrasonographic thyroid volume assessment in Delhi children revealed high goitre prevalence, with WHO standards underestimating findings. This highlights the need for refined diagnostic criteria in pediatric populations.
Area of Science:
- Pediatric Endocrinology
- Diagnostic Imaging
- Public Health Nutrition
Background:
- Ultrasonography is a key tool for evaluating thyroid volume to determine iodine deficiency prevalence.
- Accurate thyroid volume assessment is crucial for understanding community-level nutritional status.
Purpose of the Study:
- To ultrasonographically assess thyroid volume in normal children residing in Delhi.
- To compare these measurements against the World Health Organization's (WHO) established reference standards.
- To evaluate the applicability of WHO standards in a specific pediatric population.
Main Methods:
- A prospective study enrolled 103 children aged 6-10 years from a pediatric outpatient clinic.
- Thyroid volume was determined using ultrasound (USG) techniques.
- Urinary iodine levels were measured via spot urine samples to assess iodine status.
Main Results:
- Clinical assessment indicated a goitre prevalence of 24.3% among the studied children.
- Approximately 61% of children exhibited mild to moderate iodine deficiency based on urinary iodine levels.
- Using WHO age-specific norms, no children met the criteria for goitre; however, using body surface area (BSA)-specific norms identified two cases.
Conclusions:
- The World Health Organization's (WHO) ultrasonographic standards for thyroid volume may underestimate goitre prevalence in pediatric populations.
- Current WHO reference standards may require adjustment or alternative methods like BSA-specific norms for more accurate goitre detection in children.
Background:
Ultrasonographic measurement of thyroid volume is increasingly being used to assess prevalence of iodine deficiency in a community.
Objectives:
To assess thyroid volume by ultrasonography in normal Delhi children, and compare them with the recently adopted WHO reference standards.
Methods:
One hundred and three children aged of 6-10 years were enrolled from the paediatric outpatient clinic in a prospective study. Thyroid volume was estimated by ultrasound, and urinary iodine levels were measured for all subjects by spot urine samples.
Results:
Goitre prevalence was 24.3% on clinical assessment. Urinary iodine levels fell in the range of mild to moderate deficiency in 61% of the children. None of the children met the WHO recommended ultrasonographic criteria for goitre (thyroid volume >97th percentile of the reference standards), when WHO age-specific norms were used for comparison. On applying body surface area (BSA)-specific norms, only two children were classified as having goitre.
Conclusions:
The WHO standards for thyroid volume by ultrasonography tended to underestimate goitre prevalence.
