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Thyroid diseases in children and adolescents
1Department of Otorhinolaryngology and Head and Neck Surgery, Jessenius Faculty of Medicine, Comenius University and Martin University Hospital, Martin, Slovakia. calkovsky1@post.sk
Insights
Pediatric thyroid nodules, though rare, require early diagnosis due to higher malignancy risk in children. Surgical intervention is a causal therapy for persistent or symptomatic thyroid disease in this age group.
Area of Science:
- Pediatric Endocrinology
- Otorhinolaryngology
- Head and Neck Surgery
Background:
- Thyroid nodules are uncommon in children (0.2%-1.8% prevalence).
- Pediatric thyroid nodules carry a higher malignancy risk compared to adults, necessitating prompt diagnosis.
- Thyroid diseases represent the second most common endocrinopathy in pediatric populations, with a higher incidence in females.
Purpose of the Study:
- To analyze pediatric patients diagnosed with nodular thyroid disease.
- To evaluate the characteristics and treatment outcomes of pediatric thyroid nodules.
Main Methods:
- Retrospective analysis of 66 pediatric patients surgically treated for nodular thyroid disease (2003-2007).
- Utilized ultrasonography, percutaneous aspiration biopsy, and peroperative histology for diagnosis.
- Surgical procedures included total thyroidectomy, hemithyroidectomy, and isthmectomy, performed after achieving euthyroid status.
Main Results:
- Positive family history noted in 48.5% of patients.
- 35% presented with hyperthyroid disease; 65% were euthyroid.
- All patients underwent surgical treatment without severe postoperative complications.
Conclusions:
- Thyroid disease management in children is a multidisciplinary challenge.
- Surgery is the causal therapy for pediatric thyroid diseases unresponsive to conservative treatment or causing mechanical symptoms.
- Early diagnosis and appropriate surgical intervention are crucial for managing pediatric thyroid nodules.
Background:
Thyroid nodules are relatively rare in children and adolescents and have a prevalence between 0.2%-1.8%. They are more often malignant in children than in adults and thus an early diagnosis is extremely important.
Objective:
The aim of the study was to analyze the group of pediatric patients with nodular thyroid diseases.
Methods:
The authors processed the documentation of 66 pediatric patients with nodular thyroid disease who have been surgically treated at the Clinic of Otorhinolaryngology and Head and Neck Surgery, JFM CU and MFH in Martin during 2003-2007.
Results:
Family history was positive in 32 patients (48.5%). Twenty-three patients (35%) had hyperfunction thyroid disease. Euthyroid status was found in 43 patients (65%). Ultrasonography examination was performed in all patients. Percutaneous aspiration biopsy was performed in 38 patients (58%) and peroperative histology in 40 patients (61%). Technecium (Tc)99m-scintigraphy was performed in 4 patients (6%). CT and MRI examination of the neck and upper mediastinum was indicated in one child. All patients were surgically treated with classical approach after achieving euthyroid stage. Total thyroidectomy was performed in 24 patients, hemithyroidectomy in 41 patients and isthmectomy was done in one patient. No severe postoperative complications were present.
Conclusion:
Thyroid diseases are the second most frequent endocrinopathy in children and adolescents with girls being more frequently affected. It is multidisciplinary problem requiring cooperation of specialists in different fields of medicine. In patients with thyroid diseases not responding to conservative treatment or with clinical signs of mechanical syndrom surgery is a causal therapy (Tab. 3, Ref. 20). Full Text (Free, PDF) www.bmj.sk.
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