Morphofunctional state of the thyroid gland in children with congenital hypothyroidism

Abstract

Background. Diseases of the thyroid gland (TG) are ranked first among all endocrine pathologies and remain one of the most difficult problems. Objective: to evaluate the morphofunctional state of the TG in children with congenital hypothyroidism (CH). Materials and methods. The work is based on survey data of 34 children with CH: ultrasound examination of the TG, determination of thyroid hormone levels (thyroid-stimulating hormone (TSH), free thyroxine, thyroglobulin). Statistical analysis was performed by standard methods using the software package StatSoft Statistica 6.0 for Microsoft Windows XP. Results. In 67.6 % of cases, the diagnosis was established according to the screening for CH, in 32.4 % — out of the screening. In 22 patients, thyroid tissue was not visualized in a typical location, or its total volume was significantly less than normal. In 12 patients, the TG was in typical place, and its volume meet norms or exceeds its upper limit. In 55.6 % of patients, we have detected cysts (in 56 % — with dystopia of the TG, in 44 % of cases — with thyroid hypoplasia). They are located paratracheally: on the left — in 66.7 %, on the right — in 13.3 %, in 20 % — on both sides. It was found a significant degree of thyroid insufficiency in patients with thyroid defects, however, in thyroid hypoplasia, the TSH level was lower (p < 0.05) compared with that of in dystopia. Burdened heredity, mainly maternal, was detected in 11.7 % of patients; almost in a third of cases, the burdened obstetric and gynecological history was observed, more than a half of mothers had abnormal labor, and post-term pregnancy occurred 2.1 times more often than in the general population. Conclusions. The incidence of congenital abnormalities of the TG in children with CH is 64.7 %; more than in half of the cases, we have determined the cysts. Severe degree of thyroid insufficiency has been registered in cases of hypoplasia of the TG.

Keywords

• congenital hypothyroidism
• thyroid gland
• morphofunctional state
• children