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患有缩性自身免疫性甲状腺炎和垂体过度增生的儿童的生长障碍
Domenico Corica1, Tiziana Abbate2, Anna Malgorzata Kucharska3
1Department of Human Pathology of Adulthood and Childhood, Unit of Pediatrics, University of Messina, Via Consolare Valeria 1, 98125, Messina, Italy. coricadomenico@hotmail.com.
Italian journal of pediatrics
|April 22, 2024
概括
在儿童中,严重的自身免疫性甲状腺炎可能会导致垂体腺增生和生长障碍. 早期诊断和levothyroxine治疗导致显著增长改善和垂体回归.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 儿科内分泌和新陈代谢学
- 儿科内分泌学研究儿童内分泌学研究
背景情况:
- 缩性自身免疫甲状腺炎 (AAT) 是一种罕见的儿科疾病,由于缺少甲状腺扩大,经常被诊断为晚期.
- 长期,严重的甲状腺功能低下症会导致儿童的垂体过度增生 (PH),导致生长失败.
- 在这些情况下,垂体体体细胞转分化可能会导致生长障碍.
研究的目的:
- 调查患有缩性自身免疫甲状腺炎 (AAT) 的儿科患者的临床表现和结果,表现为生长障碍和垂体过度增生.
- 突出查低甲状腺功能障碍症的重要性,在儿童有不明原因的生长问题.
主要方法:
- 在五个高度增长障碍中心对十二名儿科患者的回顾性评估.
- 综合性临床,生化和放射性评估,包括甲状腺功能测试,甲状腺超声波和脑MRI.
- 利沃甲氧胺替代疗法和定期随访12个月.
主要成果:
- 75%的患者出现了身高增长停止,并且所有人都患有由于AT而导致的甲状腺功能低下,而没有甲状腺扩大.
- 大脑MRI显示,在所有患者中都有对称的 pituitary adenohypophysis扩大.
- 在88%的患者中,Levothyroxine治疗导致了显著的身高增长改善,甲状腺功能正常化和下垂体过度增生完全回归.
结论:
- 这项研究代表了最大的严重自身免疫性原发性甲状腺功能低下症的小儿科队列,而没有,其特征是下垂体增生和显著的生长障碍.
- AAT表型可能与这种特定的临床表现有关.
- 儿童患有生长障碍的患者必须考虑甲状腺功能下降,即使没有明显的甲状腺功能障碍迹象.
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