Yıl: 2021 Cilt: 14 Sayı: 1 Sayfa Aralığı: 89 - 93 Metin Dili: İngilizce DOI: 10.31362/patd.757281 İndeks Tarihi: 15-06-2021

Outcomes of thyrotoxicosis in childhood and adolescence-single center experience

Öz:
Purpose: To evaluate the clinical and biochemical features and treatment outcomes of chilhood and adolescencethyrotoxicosis.Materials and methods: Medical records of the patients who had been diagnosed with thyrotoxicosis between2015 and 2019 in the pediatric endocrinology clinic were screened retrospectively.Results: Of the 18 patients, 14 (77.7%) were females, 4 were (22.2% ) males. The median age at diagnosiswas 14.58±2.1 years. Fifteen (83.3%) patients had been diagnosed with Graves’ disease and 3 (16.6%)patients had hashitoxicosis. The most common presenting complaints among patients with GD were malaise,tachycardia/palpitation and swelling in the neck. The other complaints were weight loss, tremor, enlargementof eyes. Twelve (66.6%) patients have family history. Goiter was detected in the physical examination of 9(50%) patients. Of the 15 patients who diagnosed with GD, 5 (33%) patients had ophthalmopathy. The meaninitial dose of methimazole was 0.4±0.3 (range 0.1-1) mg/kg/day and median follow-up duration was 22.3±6.3months. Two of 3 patients diagnosed with hashitoxicosis were managed only with beta blocker and one patientdid not need any treatment. Eleven (73%) of 15 GD patients received beta blocker initially. The mean initial doseof beta blocker was 31.6±10.2 (range 20-80) mg/day. Side effects were not seen in any of 15 patients treatedwith methimazole.Conclusion: Graves’ disease and hashitoxicosis are the most common form of thyrotoxicosis in both childrenand adults. These two diseases should be distinguised at diagnosis since the prognosis is better in hashitoxicosisHowever, there is no evidence-based strategy for the management of childhood thyrotoxicosis, methimazol is thefirst treatment option in Graves’ disease. More experience of treatment responses are essential to understandthyrotoxicosis in children and adolescents.
Anahtar Kelime:

Çocuk ve adölesan tirotoksikosiz vakalarının değerlendirilmesi-tek merkez deneyimi

Öz:
Amaç: Çocukluk ve adölesan çağındaki tirotoksikozis vakalarının klinik ve biyokimyasal özelliklerini, tedavi sonuçlarını değerlendirmek. Gereç ve yöntem: 2015-2019 yılları arasında pediatrik endokrin kliniğinde tirotoksikozis tanısıyla izlenen hastaların dosyaları geriye dönük incelendi. Bulgular: Çalışmaya dahil edilen 18 hastanın 14’ü (%77,7) kız, 4’ü (%22,2) erkekti. Tanı anındaki ortalama yaş 14,58±2,1 yıldı. On beş (%83,3) hasta Graves hastalığı, 3 (%16,6) hasta ise hashitoksikoz tanısı aldı. Graves hastalığı tanısı alan hastaların en sık başvuru şikayetleri halsizlik, taşikardi/çarpıntı, boyunda şişlikti. Diğer şikayetler, kilo kaybı, tremor ve gözde büyümeydi. On iki (%66,6) hastada hipertiroidi açısından aile öyküsü pozitifti. Dokuz (%50) hastanın fizik muayenesinde guatr saptandı. Graves hastalığı tanısı alan 15 hastanın 5 (%33)’inde oftalmopati vardı. Metimazol başlangıç dozu 0,43±0,3 (0,1-1) mg/kg/gün ve ortalama izlem süresi 22,3±6,3 aydı. Hashitoksikoz tanısı alan 3 hastanın 2’sinin semptomları sadece beta-bloker tedavisiyle kontrol altına alınırken bir hastanın hiçbir medikal tedaviye ihtiyacı olmadı. 15 Graves hastasının 11 (%73)’ine tedavi başında beta bloker başlandı. Ortalama beta bloker dozu 31,6±10,2 (20-80) mg/gün saptandı. Metimazol başlanan hiçbir hastanın izleminde yan etki görülmedi. Sonuç: Graves hastalığı ve hashitoksikoz çocukluk ve adölesan dönemde görülen tritoksikoz vakaların çoğunu oluşturur. Hashitoksikozun prognozu daha iyi olduğu için bu iki hastalığı başlangıçta ayırt etmek gereklidir. Her ne kadar çocukluk ve adölesan çağı tirotoksikoz tedavisi için kanıta dayalı stratejiler olmasa da metimazol tedavide ilk seçenektir. Çocukluk ve adölesan çağı tirotoksikozu anlayabilmek için daha çok merkezin deneyimlerini paylaşmasına ihtiyaç vardır.
Anahtar Kelime:

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APA SAGSAK E (2021). Outcomes of thyrotoxicosis in childhood and adolescence-single center experience. , 89 - 93. 10.31362/patd.757281
Chicago SAGSAK ELIF Outcomes of thyrotoxicosis in childhood and adolescence-single center experience. (2021): 89 - 93. 10.31362/patd.757281
MLA SAGSAK ELIF Outcomes of thyrotoxicosis in childhood and adolescence-single center experience. , 2021, ss.89 - 93. 10.31362/patd.757281
AMA SAGSAK E Outcomes of thyrotoxicosis in childhood and adolescence-single center experience. . 2021; 89 - 93. 10.31362/patd.757281
Vancouver SAGSAK E Outcomes of thyrotoxicosis in childhood and adolescence-single center experience. . 2021; 89 - 93. 10.31362/patd.757281
IEEE SAGSAK E "Outcomes of thyrotoxicosis in childhood and adolescence-single center experience." , ss.89 - 93, 2021. 10.31362/patd.757281
ISNAD SAGSAK, ELIF. "Outcomes of thyrotoxicosis in childhood and adolescence-single center experience". (2021), 89-93. https://doi.org/10.31362/patd.757281
APA SAGSAK E (2021). Outcomes of thyrotoxicosis in childhood and adolescence-single center experience. Pamukkale Tıp Dergisi, 14(1), 89 - 93. 10.31362/patd.757281
Chicago SAGSAK ELIF Outcomes of thyrotoxicosis in childhood and adolescence-single center experience. Pamukkale Tıp Dergisi 14, no.1 (2021): 89 - 93. 10.31362/patd.757281
MLA SAGSAK ELIF Outcomes of thyrotoxicosis in childhood and adolescence-single center experience. Pamukkale Tıp Dergisi, vol.14, no.1, 2021, ss.89 - 93. 10.31362/patd.757281
AMA SAGSAK E Outcomes of thyrotoxicosis in childhood and adolescence-single center experience. Pamukkale Tıp Dergisi. 2021; 14(1): 89 - 93. 10.31362/patd.757281
Vancouver SAGSAK E Outcomes of thyrotoxicosis in childhood and adolescence-single center experience. Pamukkale Tıp Dergisi. 2021; 14(1): 89 - 93. 10.31362/patd.757281
IEEE SAGSAK E "Outcomes of thyrotoxicosis in childhood and adolescence-single center experience." Pamukkale Tıp Dergisi, 14, ss.89 - 93, 2021. 10.31362/patd.757281
ISNAD SAGSAK, ELIF. "Outcomes of thyrotoxicosis in childhood and adolescence-single center experience". Pamukkale Tıp Dergisi 14/1 (2021), 89-93. https://doi.org/10.31362/patd.757281