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Hypothyroidism in Pediatric Population - Bosnian and Herzegovinian Situation
Edo Hasanbegovic1, Snijezana Hasanbegovic2, Edin Begic2
1Pediatric Clinic, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
Insights
Pediatric hypothyroidism is more common in females and often associated with other conditions. Early diagnosis and thyroid-stimulating hormone (TSH) monitoring are crucial for effective L-thyroxine treatment in children.
Area of Science:
- Pediatric Endocrinology
- Thyroidology
Background:
- Thyroid diseases rank second in frequency among pediatric endocrine disorders.
- Accurate interpretation of thyroid function tests requires age-specific reference ranges for TSH, thyroid hormones, binding proteins, and calcitonin.
Purpose of the Study:
- To analyze the age and sex distribution of pediatric hypothyroidism patients.
- To evaluate diagnostic methods, etiologies, and therapeutic strategies for childhood hypothyroidism.
Main Methods:
- Retrospective study of pediatric patients (0-18 years) diagnosed with hypothyroidism.
- Analysis included patient demographics, diagnostic findings, etiology, and treatment regimens.
Main Results:
- Hypothyroidism predominantly affects females (65.93%) with no significant age-related incidence.
- Ultrasound confirmed struma in 50% of cases, often associated with Hashimoto's thyroiditis.
- The most common etiology was hypothyroidism associated with other conditions (29.67%), while congenital hypothyroidism accounted for 19.78%.
Conclusions:
- Congenital hypothyroidism represents approximately one-fifth of pediatric cases.
- Thyroid-stimulating hormone (TSH) levels are critical for diagnosis and therapy adjustment.
- Early diagnosis of congenital hypothyroidism (average 12 days) and L-thyroxine treatment are essential for optimal outcomes.
Introduction:
Thyroid gland diseases in children are in second place by frequency among all endocrine disorders. When interpreting the results of the thyroid function assessment it should be taken into account the significant differences in the concentrations of TSH, thyroid hormones, thyroid binding proteins and calcitonin among children of different ages.
Goal:
To present the age and sex structure of the patients diagnosed with hypothyroidism, evaluate diagnostic methods for making diagnosis, evaluation of etiology of hypothyroidism, with special review of the therapeutic modality.
Patients And Methods:
The study have retrospective character and includes all patients who have the diagnosis of hypothyroidism, but at the moment of data collection were aged 0-18 years.
Results:
Distribution of patients on the basis of gender, revealed more significant representation of female (65.93%), and without significant difference in the presence of the disease in relation to age (p>0.05). Physical examination of the struma was not verified in the majority of cases (74; 81.32%, p<0.05) suffering from hypothyroidism. Ultrasound review in 22 (50%) cases confirmed the struma. Ultrasound findings in most cases 14 (31.81%) demonstrated diffuse struma and Hashimoto thyroiditis together. In relation to the etiology of hypothyroidism most patients belong to a group where hypothyroidism is associated with other diseases and conditions (27; 29.67%), but the least with congenital hypothyroidism with 18 (19.78%) cases. The average dose of L-thyroxine in the age of 0-1 months was 50 mg, 1 month-10 years 37.5 mcg, and the group of patients over 10 years 65 mcg.
Conclusion:
Congenital hypothyroidism has about one-fifth of patients. Physical examination revealed in about one fifth of patients the struma of the thyroid gland; TSH levels is critical for the diagnosis and correction of therapy in pediatric patients with hypothyroidism. Congenital hypothyroidism is diagnosed on average at the age of 12 days, which is optimal for period for therapeutic response; Substitution treatment is carried out with L-thyroxine which is relatively reduced in doses from neonatal age onwards.
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