scholarly journals Clinical Characteristics and Follow-Up of 19 Children With Hashimoto’s Thyroiditis Aged Below 3 Years: A Single-Center Retrospective Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Shi Tang ◽  
Min Yang ◽  
Dan Zhang ◽  
Ya-jie Tong ◽  
Ying Xin
Keyword(s):  
Early Diagnosis ◽  
Developmental Delay ◽  
Thyroid Function ◽  
Subclinical Hypothyroidism ◽  
Hashimoto’S Thyroiditis ◽  
Clinical Characteristics ◽  
Diagnosis And Treatment ◽  
Hashimoto's Thyroiditis ◽  
Global Developmental Delay

AimTo analyze the clinical characteristics of Hashimoto’s thyroiditis (HT) in children below 3 years of age in order to improve the understanding of the disease, avoid misdiagnosis, and achieve early diagnosis and treatment.MethodsThe study retrospectively analyzed the clinical data of 19 patients diagnosed with HT in the first three years of life.ResultsThe patients (12 female, 7 male) had an average age of 26.1 ± 8.2 months (range 10–36 months). At presentation, one patient had euthyroidism, ten had hypothyroidism, seven had subclinical hypothyroidism, and one had hyperthyroidism. The most common reasons for doctor’s visits were thyroid enlargement (21.1%), global developmental delay (21.1%), and routine thyroid function tests in patients with type 1 diabetes (26.3%). Sixteen patients provided follow-up data, and the mean follow-up time was 23.31 ± 16.44 months (range 1–48 months). In the hypothyroidism group, one patient stopped levothyroxine (LT4) treatment after 2 months; the remaining patients had been treated with LT4 since their diagnosis. In the subclinical hypothyroidism group, one patient whose thyroid function returned to normal after 1 month of being diagnosed was not treated. The remaining patients received LT4 treatment at their diagnosis or during follow-up. The patient with hyperthyroidism was treated with methimazole after diagnosis, but treatment was discontinued 11 months later and LT4 was initiated 26 months after diagnosis. One in four patients with global developmental delay approached normal mental development after LT4 treatment. Four in six patients with short stature achieved height catch-up.ConclusionAt their initial HT diagnosis, most of the children showed hypothyroidism or subclinical hypothyroidism. Children with global developmental delay require continual screening, even if the thyroid function is normal after birth, to determine whether they have HT-induced hypothyroidism. Thyroxine replacement could partially relieve the clinical manifestations of hypothyroidism and early diagnosis and treatment are essential for improving patient prognosis.

scholarly journals Effect of small doses of iodine on thyroid function in patients with Hashimoto's thyroiditis residing in an area of mild iodine deficiency

1998 ◽  
pp. 23-28 ◽  
Author(s):  
W Reinhardt ◽  
M Luster ◽  
KH Rudorff ◽  
C Heckmann ◽  
S Petrasch ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Function ◽  
Iodine Deficiency ◽  
Subclinical Hypothyroidism ◽  
Hashimoto’S Thyroiditis ◽  
Thyroid Volume ◽  
Treated Group ◽  
Hashimoto's Thyroiditis ◽  
Control Group ◽  
Small Doses

OBJECTIVE: Several studies have suggested that iodine may influence thyroid hormone status, and perhaps antibody production, in patients with autoimmune thyroid disease. To date, studies have been carried out using large amounts of iodine. Therefore, we evaluated the effect of small doses of iodine on thyroid function and thyroid antibody levels in euthyroid patients with Hashimoto's thyroiditis who were living in an area of mild dietary iodine deficiency. METHODS: Forty patients who tested positive for anti-thyroid (TPO) antibodies or with a moderate to severe hypoechogenic pattern on ultrasound received 250 microg potassium iodide daily for 4 months (range 2-13 months). An additional 43 patients positive for TPO antibodies or with hypoechogenicity on ultrasound served as a control group. All patients were TBII negative. RESULTS: Seven patients in the iodine-treated group developed subclinical hypothyroidism and one patient became hypothyroid. Three of the seven who were subclinically hypothyroid became euthyroid again when iodine treatment was stopped. One patient developed hyperthyroidism with a concomitant increase in TBII titre to 17 U/l, but after iodine withdrawal this patient became euthyroid again. Only one patient in the control group developed subclinical hypothyroidism during the same time period. All nine patients who developed thyroid dysfunction had reduced echogenicity on ultrasound. Four of the eight patients who developed subclinical hypothyroidism had TSH concentrations greater than 3 mU/l. In 32 patients in the iodine-treated group and 42 in the control group, no significant changes in thyroid function, antibody titres or thyroid volume were observed. CONCLUSIONS: Small amounts of supplementary iodine (250 microg) cause slight but significant changes in thyroid hormone function in predisposed individuals.

scholarly journals The Recovery of Thyroid Function in Low-Risk Papillary Thyroid Cancer After Lobectomy: A 3-Year Follow-Up Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Yi Dou ◽  
Yingji Chen ◽  
Daixing Hu ◽  
Xinliang Su
Keyword(s):  
Risk Factors ◽  
Thyroid Function ◽  
Hashimoto’S Thyroiditis ◽  
Low Risk ◽  
Hashimoto's Thyroiditis ◽  
First Year ◽  
Papillary Thyroid ◽  
Normal Thyroid ◽  
Normal Thyroid Function

PurposeManagement strategies after lobectomy for low-risk papillary thyroid carcinoma (PTC) are controversial. This study aimed to identify the proportion of patients among low-risk PTC patients who do not require hormone replacement therapy and to evaluate the risk factors for postoperative hypothyroidism after lobectomy.Patients and MethodsThe records of 190 PTC patients who underwent thyroid lobectomy from January 2017 to December 2018 were retrospectively reviewed. Clinicopathological characteristics and follow-up data were collected. Univariate and multivariate analyses were performed to identify the risk factors associated with postoperative hypothyroidism and the recovery of thyroid function.ResultsIn summary, 74.21% of patients (141/190) had normal thyroid function without levothyroxine supplementation, while 40.53% (77/190) developed temporary or permanent hypothyroidism. Multivariate analysis indicated that higher preoperative thyroid-stimulating hormone (TSH) levels (>2.62 mIU/L), Hashimoto’s thyroiditis (HT), and right lobectomy were associated with hypothyroidism (all P<0.05). The Area Under Curve (AUC) by logistic analysis was 0.829. Twenty-eight (28/77, 36.4%) patients recovered to the euthyroid state in the first year after surgery, and this recovery was significantly associated with preoperative TSH level. Forty-nine (49/77, 63.6%) patients developed persistent hypothyroidism. The thyroid function of most patients (11/28, 39.3%) recovered in the third month after surgery.ConclusionPatients with a lower level of preoperative TSH, with left lobectomy and without Hashimoto’s thyroiditis had a higher chance of normal thyroid function within the first year after lobectomy. The recovery of thyroid function was associated with the level of preoperative TSH.

scholarly journals Ten-Year Follow-Up Study of Thyroid Function in Euthyroid Patients with Simple Goiter or Hashimoto's Thyroiditis.

1995 ◽  
Vol 34 (5) ◽  
pp. 371-375 ◽  
Author(s):  
Akira SATO ◽  
Toru AIZAWA ◽  
Yoichi KOIZUMI ◽  
Ichiro KOMIYA ◽  
Kazuo ICHIKAWA ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Hashimoto’S Thyroiditis ◽  
Hashimoto's Thyroiditis ◽  
Follow Up Study

scholarly journals Retrospective Analysis of Hashimoto’s Thyroiditis in Children and Adolescents: A Single Center Experience

2021 ◽  
Author(s):  
Selma Tunç ◽  
Behzat Özkan
Keyword(s):  
Celiac Disease ◽  
Autoimmune Diseases ◽  
Children And Adolescents ◽  
Subclinical Hypothyroidism ◽  
Hashimoto’S Thyroiditis ◽  
Hashimoto's Thyroiditis ◽  
Overt Hypothyroidism ◽  
Healthy Children ◽  
Thyroid Ultrasonography

Objective: Hashimoto’s thyroiditis is an organ-specific autoimmune disease and the most common cause of goiter and acquired hypothyroidism in children and adolescents in regions devoid of endemic iodine deficiency. In this study, it was aimed to examine the epidemiological, clinical and laboratory features of Hashimoto’s thyroiditis and autoimmune diseases accompanying Hashimoto’s thyroiditis in children and adolescents. Methods: We retrospectively examined thyrotropin, free thyroxin, thyroid autoantibodies (thyroid peroxidase and thyroglobulin antibodies), immunoglobulin A (IgA), anti-tissue transglutaminase antibodies (IgA-tTG), and thyroid ultrasonography findings of 108 cases aged 5-18 years with positive anti-thyroid antibodies. Results: The female/male ratio was 80/28 and 68% of the patients were adolescents. The most common admission complaint was goiter. At the time of diagnosis, the cases had euthyroidism (44.4%), subclinical hypothyroidism (35%), overt hypothyroidism (16.6%), and hyperthyroidism (3.7%). Goiter was detected in 58 (53.7%) cases by thyroid ultrasonography. During the follow-up, overt hypothyroidism developed in 6 patients who had subclinical hypothyroidism and subclinical hypothyroidism developed in 8 patients who had euthyroidism. All patients with hyperthyroidism became euthyroid. Levothyroxine treatment was administered to 47 (43.5%) patients. Celiac disease was detected in 2 and type 1 diabetes mellitus in 1 patient. Conclusions: The prevalence of Hashimoto’s thyroiditis increases with age both in childhood and adolescence, and thyroid functions tend to deteriorate over time. Therefore, close follow-up and appropriate treatment are important. Although the prevalence of celiac disease is higher in children and adolescents with Hashimoto’s thyroiditis compared to healthy children, the true prevalence of autoimmune diseases accompanying Hashimoto’s thyroiditis will be revealed in studies to be conducted in larger patient populations.

Complications and Sequelae in Patients With Congenital Microcephaly Associated With Zika Virus Infection: Two-Year Follow-Up

2021 ◽  
pp. 088307382098316
Author(s):  
Luane A. Gouvea ◽  
Marlos Martins ◽  
Daniela Vivacqua ◽  
Julia Rosseto ◽  
Giulia Lima ◽  
...  
Keyword(s):  
Developmental Delay ◽  
Zika Virus ◽  
Median Number ◽  
Global Developmental Delay ◽  
Spastic Diplegia ◽  
Long Term Follow Up ◽  
Congenital Microcephaly ◽  
Auditory Impairment ◽  
Worse Prognosis

Background: We aim to describe the long term follow-up of a cohort of children exposed in utero to the Zika virus. Methods: Descriptive study of a cohort of microcephalic children due to Zika virus. Logistic regression was used to evaluate variables associated with worse prognosis epilepsy. Results: We followed 28 children (15 females), with a median follow-up of 24 months (IQR = 12-28). During the follow-up, 1 infant died. The median head circumference at birth was 29 cm (IQR = 27-31). All presented a global developmental delay. The most frequent central nervous system abnormalities were on cortical development in 22 participants; dysgenesis of corpus callosum in 13; ventriculomegaly in 25; and calcifications in 24. A total of 9 presented ocular abnormalities, 4 auditory impairment. During follow-up, 12 presented with sleep disorders, 10 with irritability, and 23 with epilepsy (2 with generalized tonic-clonic, 3 with generalized tonic-clonic and spasms, 12 with spasms, 3 tonic and spasms, and 3 motor focal and spasms). The median age at the begin of the epilepsy was 4 months (IQR = 2-10), the median number of drugs used to control the epilepsy was 2 (IQR = 2-3). Maternal illicit drug use during pregnancy was associated with worse prognosis epilepsy (Lennox-Gastaut syndrome, West syndrome, or status epilepticus). A total of 19 presented with dysphagia, 10 children required gastrostomy. Conclusion: Children with microcephaly due to Zika virus presented with several complications during follow-up, as epilepsy, spastic diplegia, and global developmental delay.

Laryngeal cancer

2021 ◽  
pp. 175573802110105
Author(s):  
Kelvin Miu
Keyword(s):  
Head And Neck Cancer ◽  
Early Diagnosis ◽  
Head And Neck ◽  
Patient Outcomes ◽  
Laryngeal Cancer ◽  
Neck Cancer ◽  
Early Recognition ◽  
Signs And Symptoms ◽  
Diagnosis And Treatment

Laryngeal cancer is a common head and neck cancer and typically presents with voice hoarseness in patients older than 60 years. Early recognition of signs and symptoms of laryngeal cancer can lead to early diagnosis and treatment, therefore improving patient outcomes. This article aims to provide an overview of the anatomy of the larynx, presentation and management of laryngeal cancer, and common follow-up problems.

scholarly journals The Effect of Iodine Restriction on Thyroid Function in Patients with Hypothyroidism Due to Hashimoto's Thyroiditis

2003 ◽  
Vol 44 (2) ◽  
pp. 227 ◽  
Author(s):  
Soo Jee Yoon ◽  
So Rae Choi ◽  
Dol Mi Kim ◽  
Jun Uh Kim ◽  
Kyung Wook Kim ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Hashimoto’S Thyroiditis ◽  
Hashimoto's Thyroiditis

scholarly journals Characteristics of seizure frequency among Malaysian children diagnosed with structural– metabolic epilepsy

2012 ◽  
Vol 03 (03) ◽  
pp. 244-250 ◽  
Author(s):  
Muhannad RM Salih ◽  
Mohd Baidi Bahari ◽  
Mohamed Azmi Ahmad Hassali ◽  
Asrul Akmal Shafie ◽  
Omer Qutaiba B Al-lela ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Developmental Delay ◽  
Seizure Frequency ◽  
Substantial Reduction ◽  
Focal Seizure ◽  
Global Developmental Delay ◽  
Neurology Clinic ◽  
Collection Form ◽  
Metabolic Epilepsy

ABSTRACT Introduction: Seizure-free patients or substantial reduction in seizure frequency are the most important outcome measures in the management of epilepsy. The study aimed to evaluate the patterns of seizure frequency and its relationship with demographics, clinical characteristics, and outcomes. Materials and Methods: A retrospective cohort study was conducted at the Pediatric Neurology Clinic, Hospital Pulau Pinang. Over a period of 6 months, the required data were extracted from the medical records using a pre-designed data collection form. Results: Seizure frequency showed no significant association with patient’s demographics and clinical characteristic. However, significant reduction in seizure frequency from the baseline to the last follow-up visit was only seen in certain subgroups of patients including Malays, females, patients <4 years of age, patients with global developmental delay/intellectual disability, and patients with focal seizure. There was no significant association between seizure frequency and rate of adverse events. Polytherapy visits were associated with higher seizure frequency than monotherapy visits (27.97 ± 56.66, 10.94 ± 30.96 attack per month, respectively) (P < 0.001). There was a clear tendency to get antiepileptic drugs used at doses above the recommended range in polytherapy (8.4%) rather than in monotherapy (1.4%) visits (P < 0.001). A significant correlation was found between seizure frequency and number of visits per patient per year (r = 0.450, P < 0.001). Conclusion: Among children with structural–metabolic epilepsy, Malays, females, patients <4 years of age, patients with global developmental delay/intellectual disability and patients manifested with focal seizure are more responsive antiepileptic drug therapy than the other subgroups of patients.

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