在非临界病的儿童中非甲状腺疾病综合征
Annemieke M V Evelein1, Rachel J van der Pol2, Karen van Wessel3
1Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands.
Pediatrics
|June 17, 2025
概括
非甲状腺疾病综合征 (NTIS) 可能发生在患有严重潜在疾病的非危急疾病儿童中. 在儿童中,高皮质醇与低T4值得对严重疾病进行调查,而不仅仅是中央甲状腺功能低下症.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 儿科瘤学 儿科瘤学
- 内部医学 内部医学
背景情况:
- 非甲状腺疾病综合征 (NTIS) 通常在重症儿童中观察到.
- 在严重疾病期间,NTIS的特征是甲状腺激素水平发生变化 (T3 / T4低,TSH正常/低).
- 区分NTIS与中央甲状腺功能障碍症可能是具有挑战性的,特别是在幼儿中.
研究的目的:
- 报告一个非危急的儿童NTIS病例.
- 强调在无法解释的中央甲状腺功能低下症中考虑严重的潜在疾病的重要性.
- 强调儿童患者NTIS的诊断红旗.
主要方法:
- 一个10个月大的男孩的病例报告显示,他无法壮成长.
- 诊断工作包括甲状腺功能测试,皮质醇水平和脑MRI.
- 对先天性下垂体和其他潜在疾病的调查.
主要成果:
- 这名患者出现了NTIS,最初怀疑是先天性下垂体.
- 观察到高皮质醇水平,这表明存在严重的潜在疾病.
- 一个神经母细胞瘤被诊断出来,随后切除.
- 手术后甲状腺功能正常化,允许停止甲状腺素补充剂.
结论:
- 在非危急病的儿童中,NTIS可以表现为具有重大潜在病理的儿童.
- 皮质醇升高与低自由T4结合,是儿科患者严重疾病的关键指标.
- 对于明显的中央甲状腺功能低下症儿童来说,彻底的诊断评估至关重要,以排除像神经母细胞瘤这样的严重疾病.
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