阿根廷的儿童格雷夫斯病:分析治疗策略和结果
Anna Rothenfusser1, Ana Chiesa1, Patricia Papendieck1
1CONICET-FEI-División de Endocrinología, Centro de Investigaciones Endocrinológicas"Dr. César Bergadá" (CEDIE), Hospital de Niños Ricardo Gutiérrez, BuenosAires, Argentina.
Journal of pediatric endocrinology & metabolism : JPEM
|December 30, 2024
概括
抗甲状腺药物治疗 (ATD) 在儿科格雷夫斯病中显示出较低的缓解率,特别是在严重甲状腺毒的西班牙裔儿童中. 由于坚持问题和对随访的丧失,通常需要进行终极治疗.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 甲状腺学 甲状腺学
- 自免疫性疾病 自免疫性疾病
背景情况:
- 格雷夫斯病是儿童甲状腺功能障碍的主要原因.
- 目前对儿科格雷夫斯病 (PGD) 的治疗方法包括抗甲状腺药物 (ATD) 和绝对疗法 (甲状腺切除术或放射性切除术).
- ATD提供了缓解的机会,但最终的治疗导致终身甲状腺功能低下症.
研究的目的:
- 评估在单一的三级医疗中心对儿科格雷夫斯病 (PGD) 的治疗结果.
- 评估缓解率,不良反应 (AR) 和需要使用ATD进行最终治疗 (DT) 的情况.
- 确定在PGD患者中缓解的潜在预测因素.
主要方法:
- 在2006年至2021年期间诊断出PGD的130名儿科患者的回顾性图表审查.
- 收集的数据包括流行病学,临床和生化特征,治疗结果,缓解状态,AR和DT.
- 在88名在中心诊断的患者中分析了缓解的预测因素.
主要成果:
- 研究人口中78%是女性,98%是西班牙裔,平均年龄为12.7岁;11%患有唐氏综合征.
- 在66%的患者诊断时存在严重的甲状腺毒性.
- 只有13%的患者在平均3.1年后通过ATD实现了缓解; 46%需要DT,31%的患者在随访后失去了. 肺炎影响了26%的患者,通常是在前3个月内. 没有发现有意义的缓解预测因素.
结论:
- 抗甲状腺药物治疗 (ATD) 在严重的格雷夫斯病的西班牙裔儿科患者中显示出较低的缓解率.
- 坚持问题和失去了随访往往需要最终治疗 (DT).
- 建议在持续的儿科格雷夫斯病 (PGD) 中考虑在4年ATD后进行最终治疗 (DT).
相关概念视频
01:26Peptic Ulcer Disease IV: Management
72
Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
72
01:28Pneumonia IV: Management
298
The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
298
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
141
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
141
01:29Inflammatory Bowel Disease IV: Pharmacological Management
111
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
111
01:28Pulmonary Tuberculosis V
170
Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
170
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
95
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
95