Thyroid diseases in a school population with thyromegaly

Area of Science:

• Pediatric Endocrinology
• Public Health
• Thyroidology

Background:

• Iodine deficiency disorders remain a public health concern globally.
• Salt iodization is a common strategy to prevent iodine deficiency.
• The prevalence of thyroid disorders in children in iodized salt regions requires ongoing surveillance.

Purpose of the Study:

• To assess the prevalence of thyroid diseases in schoolchildren in Sibenik, Croatia, a region with iodized salt.
• To identify specific thyroid conditions and their distribution among the pediatric population.
• To evaluate the effectiveness of current iodine prophylaxis and the need for further screening.

Main Methods:

• A cross-sectional survey of 5462 schoolchildren was conducted.
• Clinical examinations for thyromegaly and thyroid nodules were performed.
• Fine needle biopsy, antibody testing (thyroglobulin, microsomal), and thyroid hormone level measurements (thyroxine, triiodothyronine, TSH) were utilized for diagnosis.

Main Results:

• A total of 2.8% of children exhibited thyromegaly, with simple goiter being the most common (2.3%).
• Juvenile autoimmune thyroiditis was diagnosed in 0.35% of children, with a female predominance.
• Graves' disease and thyroid nodules were less common, affecting 0.07% and 0.055% respectively.
• Only a small fraction of affected children had previously sought medical advice, indicating a significant number of undiagnosed cases.

Conclusions:

• Despite adequate salt iodization, thyroid disorders are prevalent in schoolchildren in Sibenik.
• Simple goiter and juvenile autoimmune thyroiditis are significant findings in this population.
• The low rate of prior medical consultation underscores the importance of systematic thyroid examinations in apparently healthy children, even in iodine-sufficient areas.