Goiter and chronic lymphocitic thyroiditisSixty patients with goiter, aged 3 to 16 years, 58 girls, were studied for evidence of chronic lymphocytic thyroiditis (CLT). Thirtyeight patients, 63%, presented two or more diagnostic elements of TLC, according to Fisher's criteria, with a high frequency of thyroid function involvement (47.4% had hypothyroidism and 18.4% had hyperthyroidism). The rest of the patients with diffuse goiter (37%) did not meet Fisher's criteria, they were mostly euthyroidal (95%) and they were designated "non thyroiditis goiter". All patients with probable CLT had positive antimiciosomal antibodies at relatively high liter (> 1 x 600 in 71 % of the cases) and 32% of them had both antimicTosomal and antithyroglobulin antibodies. In the "non thyroiditis goiter" group we found 28% of children with positive antimicrosomal antibodies at low tilers (1 x 100 and 1 x 400, respectively). In a control group of 28 children of similar ages, without endocrine diseases neither familiar history of thyroid diseases only 3 (11%) cases showed positive antimicrosomal antibodies, always at low serum titers. (Key words: goiter, lymphocitic thyroiditis, diagnosis, circulating antibodies, antimicrosomal antibodies, antithyroglobulin antibodies.) El bocio es la afeccion tiroidea de mayor consulta en nifios y adolescentes. Su aparicion puede ser el resultado de multiples factores: estimulacion de la glandula tiroidea por aumento de la hormona tirotrofica (TSH) secundaria a dishormonogenesis; anticuerpos estimulantes del tiroides, como sucede en la enfermedad de Graves; infiltracion del tiroides por quisles, tumores benignos o malignos u otras enfermedades o inflamacion de la glandula tiroides de etiologia autoinmune, infecciosa, viral bacteriana o traumatica. En el desarrollo del bocio puede estar comprometido mas de un mecanismo. Asi, por ejemplo, en enfermedades tiroideas autoinmunes, como la tiroiditis linfocitaria cronica (TLC), por lo general la glandula es infiltrada por linfocitos y foliculos linfoides y, ademas, puede estar estimulada por exceso de hormona tiroestimulante (TSH).En Chile la carencia de yodo era una causa frecuente de bocio, problema que deberia haber mejorado por lo menos en parte mediante la suplementacion con yodo de la sal de mesa, de 198acuerdo con la Iegislaci6n que se esta aplicando desde 1978 1 ' 2 . No obstante, el bocio continua siendo frecuente en ninos y adolescentes, por lo que deben plantearse otras etiologias. Estudios efectuados en otros pai'ses tienden a demostrar que la TLC sen'a causa importante de bocio en nifios 3~7 . El diagnostico de certeza de TLC se hace mediante biopsia tiroidea, pero por la naturaleza invasiva de este procedimiento se han buscado otros medios para orientar el diagnostico. Fisher ha propuesto que la asociacion de dos o mas de los siguientes elementos sugiere la presencia de TLC 8 : bocio difuso de superficie finamente granular; cintigrafia algo irregular; anticuerpos antitiroideos por hemaglutinacion positives; concentration elevada de TSH en el sue...

Clinical aspects of thyroid carcinoma in children Nine patients with thyroid carcinoma, 4 boys and 5 girls, aged 3 to 16 years are described. Their clinical signs went on from hard goiter, through those of mild symptoms of local compression, to evidence of metastases. Thyroid function was normal in these patients and thyroid scintigraphic scans revealed focal low or absent radio iodine uptake. The pathologic study revealed in all them differenciated thyroid carcinomas: 4 papillary cancers associated to chronic thyroidits in 3; 3 cases of papillar-folicular carcinomas and 2 of medullar carcinomas without familiar antecedents. The treatment of choice was total thyroidectomy, for possible multifocal compromise, together with affected adjacent lymph nodes remotion. Post-operative thyroid hormone treatment at TSH suppressive dose was also indicated. Post operative evolution was satisfactory, but secondary hypoparathyroidism ocurred in 3 patients. Early diagnosis of thyroid carcinoma affords relatively good prognosis.

Fourteen girls with hirsutisn, aged 12.5 to 16 years, were prospective!-/ studied. Patients with adrenal tumors, pnmary ovary disease or classical congenital adrenal hyperplasia were excluded from this study. Hirsutism was evaluated by the Ferriman score. All patients had normal weight and blood pressure. Urinary 17 hydroxicorticosteroids, pregnanetriol and dehydroepiandrosterone were measured in 24 hour urine samples. Lh, FSH, cortisoi, 1 7-hidroxyprogesterone (17-OhP), dehydroepiandrosterone sulfate (DHEAS) and testosterone in plasms were also measured Defore and 60 min after .ntravenous injection of rapidly acting ACTH (0.25 mg). Ultrasonography of the ovary was also done to each patient. Two patients were probably heterozygotus for 21-hydroxylase deficiency, nine other girls showed high blood levels of DHtAS (average 8289 ng/ml) but in three cases no apparent cause was detected and they were labeled as idiopatic hirsutism. The two patients with evidence of heterozygosity for 21-hidroxylase deficiency and b patients with high DHEAS improved after dexametasone treatment and normalization of their olood ievels of 1 7-OHP and DHEA-S respectively.

Some anthropometric characteristics in male Chilean adolescents, of mid-high socioeconomic level were registered as part of a larger research dealing with the clinical, psychological and cultural characteristics of Chilean adolescents. Observed values for height, weight and growth spurt time were similar to those described for British adolescents (Tanner) and are significantly higher than those observed in the Chilean adolescents from a lower socioeconomical stratum. It is postulated that height is more influenced by socioeconomical conditions than by genetic factors. Trunk and extremities grow in the same proportions during adolescence. The growth of the thrunk coincides with the growth's spurt at 14 years of age. The extremities grow in two peaks, the first at 10 years and the second at 14 years. (Key words: Body, growth, adolescent, males).Los cambios biologicos son un fenomeno tan evidente en la adolescencia que incluso se han usado como indicadores del inicio de esta etapa. En nuestro pai's no contamos con muchos estudios acerca del patron caracteristico del desarrollo biologico del adolescente y tarnpoco disponemos de estudios empiricos acerca de su interrelacion con el desarrollo psicologico. Pensamos que para lograr resolver estos problemas es indispensable un trabajo interdisciplinario usando

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