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Characterization of Hashimoto´s thyroiditis in Sudanese children: a cross-sectional study at Gaafar Ibnauf Hospital,
Ghassan Faisal Fadlalbari1, Salwa Abdelbagi Musa1, Samar Sabir Hassan1
1Gaafar Ibnauf Pediatric Tertiary Hospital, Pediatric Endocrinology Unit, Khartoum, Sudan.
Insights
Hashimoto's thyroiditis is common in Sudanese children, with goiter and hypothyroidism being frequent. Most patients require long-term levothyroxine therapy for managing this autoimmune thyroid disease.
Area of Science:
- Pediatric Endocrinology
- Autoimmune Diseases
- Thyroid Disorders
Background:
- Literature on Hashimoto's thyroiditis in African children is limited.
- Hashimoto's thyroiditis is a prevalent autoimmune thyroid condition in young populations.
Purpose of the Study:
- To investigate the clinical profile and outcomes of Hashimoto's thyroiditis in Sudanese children and adolescents.
- To address the scarcity of data on this condition in the region.
Main Methods:
- Retrospective review of 73 pediatric patients diagnosed with Hashimoto's thyroiditis.
- Data collection included demographics, clinical presentation, family history, comorbidities, and biochemical progression.
Main Results:
- The majority of patients (80.8%) were female, with a mean age of 10.6 years at diagnosis.
- Common symptoms included thyromegaly (goiter) and fatigue; 60.3% presented with overt hypothyroidism.
- Long-term levothyroxine therapy was required for most patients with overt or subclinical hypothyroidism to maintain euthyroid status.
Conclusions:
- Goiter is the most common presenting feature of Hashimoto's thyroiditis in this cohort.
- Most pediatric patients with Hashimoto's thyroiditis in Sudan develop overt or subclinical hypothyroidism and necessitate lifelong treatment.
Introduction:
literature on Hashimoto´s thyroiditis, the common thyroid illness in the young populations, in Sudan and Africa is scarce. We aimed to study its clinical profile and outcome among Sudanese children and adolescents.
Methods:
records of 73 patients were reviewed. Data related to demographics, presenting features, family history and coexistence of autoimmune diseases, physical examination findings, and biochemical progression over time were obtained.
Results:
patients´ mean age at the diagnosis was 10.6 ± 2.9 years, 80.8% (n = 59) of them were female and 83.6% (n = 61) were residing in iodine-sufficient areas. The commonest presenting features were thyromegaly and fatigability (79.5%, n = 58 and 43.8%, n = 32, respectively) after an illness duration of 0.5-48 months. Autoimmune comorbidities were documented in 8.2% (n = 6) of our series and more than half (53.4%, n = 39) of them were pre-pubertal at the diagnosis. Sixty point three percent (60.3%) (n = 44), 20.5% (n = 15), 13.7% (n = 10) and 5.5% (n = 4) of patients presented with overt hypothyroidism, sub-clinical hypothyroidism, euthyroidism and hyperthyroidism respectively, and there were no significant differences in the clinical profile between them. In patients' continued follow-up, 94.1% (n = 32/34) of those presented with overt hypothyroidism required levothyroxine therapy to maintain euthyroidism for 0.5-13 years, while 85.7% (n = 6/7) of those with euthyroidism remained so for 0.5-6 years. Remission was reported in all hyperthyroid patients and in only 5.9% (n = 2/34) of those with overt hypothyroidism at diagnosis. The majority of our patients with subclinical hypothyroidism were treated with levothyroxine and continued to be euthyroid for 10 months to 13 years.
Conclusion:
goiter was the commonest presenting feature of Hashimoto´s thyroiditis. The majority of patients had overt or subclinical hypothyroidism and almost all of them required long-term levothyroxine therapy.
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