Çocuk Ve Adolesanlarda Hashi̇moto Ti̇roi̇di̇ti̇ / Hashimoto Thyroiditis in Children and Adolescents

Abstract

ÖZET: Hashimoto tiroiditi (HT) çocukluk yaş grubunda hipotiroidinin en sık sebebi olup guatr ya da atrofik tiroidit olarak karşımıza çıkabilir. Çeşitli hücre ve antikor aracılı immün sürece ve lenfositik infiltrasyona bağlı gelişen tiroid foliküllerinin harabiyeti ile karakterizedir. Etiyolojik olarak genetik yatkınlığı olan bireylerde çevresel faktörlerin etkisiyle ortaya çıktığı düşünülmektedir. HT tanısı serumda tiroid antijenlerine karşı gelişen (özellikle peroksidaz ve tiroglobulin) antikorların gösterilmesine dayanır. Ancak HT'li hastaların % 10-15'inde antikorlar negatif saptanabilir. Hastalar nonspesifik semptomlara sahip olup rutin tiroid fonksiyon testleri ile tanı alabilirler. HT değişken klinik prezentasyona sahiptir ve hastalar hipertiroid, hipotiroid veya ötiroid olabilir. Hipotiroidizm ile birlikte sık görülen semptomlar; halsizlik, soğuk intoleransı, konstipasyon, cilt kuruluğu, boy kısalığı ve kilo almadır. Klinik bulgular hipotiroidizmin derecesine bağlı olarak değişebilir. HT'de alopesi, vitiligo, çölyak hastalığı, addison hastalığı, tip 1 diyabet ve poliglandüler sendromlar gibi diğer otoimmün hastalıklar eşlik edebilir. HT tedavisinde klinik ve biyokimyasal olarak ötiroidiyi sağlamak amacıyla tiroid hormon replasmanı (levotiroksin) yapılmaktadır.. ANAHTAR KELIMELER: Hashimoto tiroiditi; adolesan; hipotiroidi; otoimmünite HASHIMOTO THYROIDITIS IN CHILDREN AND ADOLESCENTSABSTRACT: Hashimoto thyroiditis (HT) is the most common cause of hypothyroidism in pediatric age group resulting in either goiter or thyroid atrophy. It is characterized by the destruction of thyroid follicles by various cell-and antibody-mediated immune processes and lymphocytic infiltration. The etiology of HT is thought to be a combination of genetic susceptibility and environmental factors. The diagnosis of HT relies on the demostration of circulating antibodies to thyroid antigens mainly thyroperoxidase and thyroglobulin. However, 10-15 % of patients with HT may be antibody negative. Patients may have subclinical nonspecific symptoms, diagnosed based on routine screening of thyroid function. HT has a highly variable clinical presentation; patients may either be hyperthyroid, hypothyroid or euthyroid. Common presenting symptoms of hypothyroidism are fatigue, cold intolerance, constipation, dry skin, short stature and weight gain. Clinical findings may vary according to the extend of the hypothyroidism. HT is associated with other autoimmune diseases such as alopecia, vitiligo, coeliac disease, addison disease, type 1 diabetes and polyglandular syndrome. The treatment of HT is thyroid hormone replacement (levothyroxine) to restore a clinically and biochemically euthyroid state.

Acoustic Radiation Force Impulse Quantification in the Evaluation of Thyroid Elasticity in Pediatric Patients With Hashimoto Thyroiditis

“…The fibrotic changes account for the high SWV values in Hashimoto thyroiditis. 15 When previously mentioned studies are evaluated, the mean SWV of the thyroid gland changes in ranges of 1.59 to 2.00 m/s in healthy individuals and 2.43 to 3,8,16,17 In this study, the mean SWV values of the healthy controls and the patients with Hashimoto thyroiditis were 1.30 6 0.13 and 1.67 6 0.63 m/s, respectively. The mean SWV values were lower compared to the adult studies performed previously.…”

“…When previously mentioned studies are evaluated, the mean SWV of the thyroid gland changes in ranges of 1.59 to 2.00 m/s in healthy individuals and 2.43 to 2.62 m/s in patients with Hashimoto thyroiditis . In this study, the mean SWV values of the healthy controls and the patients with Hashimoto thyroiditis were 1.30 ± 0.13 and 1.67 ± 0.63 m/s, respectively.…”

“…Girls are affected 4 times more often than boys. This condition is an organ‐specific autoimmune disease with lymphocytic infiltration of the thyroid gland . The pathologic process continues with the fibrosis in the thyroid gland, which results in increased tissue stiffness .…”

“…This condition is an organ-specific autoimmune disease with lymphocytic infiltration of the thyroid gland. [6][7][8] The pathologic process continues with the fibrosis in the thyroid gland, which results in increased tissue stiffness. [5][6][7] The aim of this study was to evaluate the microstructural changes, including inflammation and fibrosis, in the thyroid gland in Hashimoto thyroiditis with ARFI elastography as well as to determine the utility of the acquired data in the diagnosis and follow-up of these patients.…”

Hi̇perti̇roi̇di̇zm Saptanan Çocuklarin Kli̇ni̇k Özelli̇kleri̇ Ve Taki̇p Sonuçlari

“…1 HT is an autoimmune disease characterized by tissue destruction caused by autoantibodies against the thyroid gland. 3 The clinical manifestations of the disease are variable. According to thyroid function tests, patients may be in a hyperthyroid, euthyroid, or hypothyroid state.…”