Cause Of Goiter Research Articles

Clinical and Laboratory Findings in Children with Hashimoto's Thyroiditis.

Hashimoto's thyroiditis (HT) is the most common cause of goiter and acquired hypothyroidism in children after iodine deficiency. In this study, clinical and laboratory findings and follow-up results of children diagnosed with HT are presented. The data of cases diagnosed with HT between 2004 and 2022 in 2 centers in Erzurum were evaluated retrospectively. Of the 81 children with HT whose ages ranged from 3 to 18 years (11.24 ± 3.72), 67 (82.7%) were girls and 14 (17.3%) were boys. The most common symptoms were neck swelling (37%), fatigue (23.5%), and hair loss (23.5%). There was a family history of HT in 12 cases (9.9%). Fifty-one (63%) of the cases were in the pubertal period and 30 (37%) were in the prepubertal period. There was no goiter in 36 (44.4%) of the patients, second degree goiter in 24 (29.6%), first degree goiter in 14 (17.3%), and third degree goiter in 7 (8.7%). Twenty-two (27.2%) of the cases were euthyroid, 27 (33.3%) were subclinical hypothyroidism, 23 (28.4%) were hypothyroidism, and 9 (11.1%) were hyperthyroidism. While 18 (22.2%) of the cases were followed up without medication, 59 (72.8%) were given levothyroxine and 4 (5%) were given methimazole. The mean follow-up time was 32.1 ± 33.7 months. The study's findings suggest that HT is more common in girls and occurs more frequently after puberty. A personal or family history of an autoimmune disease may be a warning sign for HT. Additionally, HT should be kept in mind in the diferential diagnosis of children presenting with complaints of neck swelling, fatigue, and hair loss.

8229 Prevalence of Thyroid Cancer in Patients with Hashimotos Thyroiditis Presenting Concomitant Thyroid Nodular Disease

Abstract Disclosure: M.A. Alvarez Castillo: None. L. Sanchez Arriaga: None. A. Segovia Palomo: None. Introduction: Hashimoto's thyroiditis (HT) is the most frequent autoimmune thyroid disease and the main cause of goiter and hypothyroidism; it induces a process of aseptic autoimmune inflammation. Fibroinflammatory changes lead to the development of thyroid nodules (TN), additionally chronic inflammation is an important player in the development of cancer, although this association is controversial. The prevalence of thyroid cancer (TC) in patients with HT ranges from 0.61-58.4% (25.01%), being higher than in patients with TN without concomitant HT. Objective: To know the prevalence of malignancy in patients with HT who present thyroid nodular disease. Methodology: An observational, descriptive, retrospective, and longitudinal study was carried out. Patients with HT diagnosis were selected by measuring Ab TPO and/or Ab TG who presented an ultrasound diagnosis of TN and FNAB of the thyroid lesion had been performed. Descriptive statistics and linear regression were used. Results: 87 patients: 6 (6.9%) men and 81 (93.1%) women aged 47.9 (12.7) years. 4 (4.5%) required FNAB in 2 TN, for a total of 91 TN studied. 64% had a diagnosis of hypothyroidism and were taking LT4, TSH 4.40 (4.44) mUI/mL, FT4 1.00 (0.27) ng/dL. Mean Ab TPO was 794.7 ± 1354.6. Diagnosis time 19.5 (29.1) months. 39.6% the detection was made by the patient and 35.2% by the doctor. Major axis was 18.8 (12.1) mm. Ultrasound pattern of single TN 58.2% and multinodular 41.8%. Median TIRADS was 4, with a mode of 5. 81.3% reported Bethesda II and 18.7% malignant or suspected, were sent for surgery, malignancy was confirmed in 16/ 17 lesions. 14 (15.3%) were TPC and 2 lymphomas, the main subtypes were classic papillary and NHL, respectively. Mode of ATA risk was intermediate. Multivariate analysis only TIRADS represented risk factor (OR 2.08) Conclusions: The frequency of TC in our population was 15.3%, which reflects a higher prevalence of malignancy in thyroid nodules in patients with chronic thyroiditis, in accordance with what has been reported in other series. Presentation: 6/3/2024

Role of Iodine Status and Lifestyle Behaviors on Goiter among Children and Adolescents: A Cross-Sectional Study in Zhejiang Province, China.

Iodine deficiency is a well-established cause of goiter, while the impact of lifestyle factors on goiter development remains underexplored. The study aims to explore the associations between iodine status, lifestyle factors, and the prevalence of goiter among children and adolescents in Zhejiang Province, China. A cross-sectional survey was conducted in 2022 using a stratified multistage sampling, involving 2261 children aged 6-17. Among these 1562 participants underwent both urinalysis and thyroid ultrasound. Lifestyle factors were assessed through self-reported questionnaires. The prevalence of goiter in the study population was 10.8%. A high urinary iodine concentration (UIC) (>300 μg/L) was significantly associated with a decreased risk of goiter (OR = 0.49, 95%CI: 0.27-0.88). Excessive recreational screen time and a high frequency of dining out were associated with an increased Tvol, while adequate physical activity and sleep were inversely associated with goiter risk, while the combined effect of high UIC and healthy lifestyle showed a protective effect against goiter. Ensuring adequate iodine status and promoting healthy lifestyles are crucial for preventing goiter and enhancing thyroid health in children and adolescents, suggesting that public health strategies should integrate nutritional and lifestyle interventions.

Grading of Hashimoto’s thyroiditis in cytology and its association with ultrasonographic and biochemical parameters

Introduction and Aim: In the post-iodization period, Hashimoto's thyroiditis (HT) is most likely the most prevalent cause of goitre and hypothyroidism, particularly in women of reproductive years. This study was undertaken to grade HT on Fine Needle Aspiration Cytology smears and determine their usefulness in predicting thyroid damage in association with clinical history, radiological and biochemical findings. Materials and Methods: Total of 151 cases were diagnosed cytologically in duration of over 2 years as Hashimoto’s thyroiditis/lymphocytic thyroiditis. Cytology scoring technique was used to analyse smears and were correlated with radiological, biochemical findings and were evaluated statistically by ANOVA and Kruskal Wallis tests. Results: In the current study, the most frequent group of individuals with Hashimoto's thyroiditis were between the ages of 40 and 50. Females (145 cases, 96%) were commonly affected and the commonest presentation was a diffuse (125 cases ,82.8%) thyroid enlargement. Cytological grading of Hashimoto’s thyroiditis were as follows,54 (35.8%) patients were Grade I, 81(53.6%) patients were Grade II thyroiditis and 16 (10.6%) patients were Grade III thyroiditis. Biochemically, 78 (56.5%) of the cases were hypothyroid, 51 (37%), euthyroid, and 9 (6.5%) were hyperthyroid. Ultrasonography revealed 76 (50.3%) patients with hypoechoic micronodules, 71 (47%) with echogenic septae, 101 (66.9%) with increased vascularity, and 6 (4%) with normal findings. The grades of lymphocytic thyroiditis and the biochemical data were found to be statistically significant (p=0.001). Furthermore, there was a strong correlation between the grades and specific ultrasound findings, such as echogenic septae (p=0.042) and diffuse hypoechogenicity (p=0.046). Conclusion: Cytological scoring system in Hashimoto’s thyroiditis can predict thyroid functional status and aid in determining the severity of the disease.

Amyloid goiter secondary to familial Mediterranean fever with E148Q mutation: A unique case.

Amyloid goiter secondary to familial Mediterranean fever with E148Q mutation: A unique case.

Cytological spectrum of diseases in goiter in Kadapa, a semiurban city in southern part of India – A 2-year retrospective study

Background: Thyroid gland produces thyroid hormone, thyroxine. Goiter is an indefinite term applied to the enlargement of thyroid gland. The normal thyroid gland in non-goitrous state weighs 25–35 g. Thyroid gland disorders are common endocrine disorders in the world. Aims and Objectives: This is a retrospective study done to know the age and gender distribution of goiter and various pathological conditions in goiter. This study showed that the incidence is common in 3rd–5th decade of life and nodular and colloid goiter are the common causes of goiter followed by follicular adenoma and papillary carcinoma. Materials and Methods: The data were collected from cytology registers of Pathology Department of FIMS Hospital, Image Diagnostics and Seetha Diagnostics, Kadapa, during the 2-year period from January 2021 to December 2022. The data collected as above were systematically analyzed and reviewed for age and sex distribution, clinical presentation, and cytological diagnosis. Results: Majority of the patients were female accounting for 324 cases (94.18%) and 20 patients (5.81%) were male. The maximum incidence is in young females between 31 and 40 years age group (24.70%) followed by 41–50 years age group (23.83%) and then in 21–30 years age group (22.38%). All together, the overall maximum incidence is seen in females between 21 and 50 years age group (70.91%). The most common pathological disease is nodular goiter followed by colloid nodule, both being iodine deficiency goiters. Conclusion: The study showed the thyroid disorders are more common in females. The non-neoplastic lesions constitute the predominant cause for goiter followed by benign neoplasms and then malignant neoplasms.

HASHIMOTO THYROIDITIS IN PAEDIATRIC POPULATION- AN OVERVIEW

The most frequent cause of goitre and acquired hypothyroidism in children and teenagers is Hashimoto's thyroiditis (HT). An imperfection or error in immunoregulation leads to a cascade of events that develops from thyroid lymphocyte infiltration to thyroid follicular cell damage caused by T cells and cytokines and apoptotic cell death. Approximately 70% of illness risk is linked to genetic predisposition, with environmental variables also contributing to disease onset in vulnerable individuals. The main reasons for referral in children and adolescents with HT include goitre, hypothyroid symptoms, and outcomes that occur while treating separate disorders or for high-risk groups. Children and adolescents with HT may not have any symptoms. Thyroid hormone replacement is the preferred medical approach for treating Hashimoto thyroiditis. Levothyroxine sodium, taken orally, is the preferred medication, typically for life. To prevent insufficient absorption, it shouldn't be administered along with calcium or iron supplements, aluminium hydroxide, or proton pump inhibitors.

Autoimmune diseases accompanying Hashimoto thyroiditis in pediatric patients

AIM: Hashimoto thyroiditis (HT) is the most common cause of goiter and acquired hypothyroidism in children and adolescents living in iodine-sufficient regions. In this study, we aimed to investigate the coexistence of other accompanying autoimmune diseases in patients aged 5–18 years who were diagnosed and followed up at the Pediatric Endocrinology Clinic of our hospital.MATERIAL AND METHODS: A total of 220 patients aged 5–18 years who were diagnosed with HT at the Pediatric Endocrinology Clinic of the University of Health Sciences Ankara City Hospital. Patient’ age at admission, sex, family history, complaints at admission, comorbidities, physical examination and laboratory findings, and clinical follow-up information were retrospectively reviewed.RESULTS: Of the 220 patients, 77.7% were female and 22.2% were male, with a mean age of 13.8±3.3 years. Of the 51.4 had euthyroidism, 40.4% had subclinical hypothyroidism,and 8.2% had overt hypothyroidism, respectively. Anti-thyroid peroxidase antibody was detected in 97% of patients and anti-thyroglobulin antibody (anti-Tg) was detected in 74% of patients. There was a family history of autoimmune disease in 36.4% of the patients. Autoimmune disease were present in 45 patients (20.4%). The most common autoimmune diseases in the patients were type 1 diabetes mellitus (T1DM) (14%), celiac disease (5%), skin diseases (2.7%), and rheumatologic diseases (1.3%). No statistically significant differences were found between the sex, age at diagnosis, current age, family history of autoimmune disease and thyroid function status of patients with HT and T1DM.The mean age of the patients followed up with HT with and without additional autoimmune disease was similar (p=0.644). In both groups, female sex was dominant. However, the number of male patients (35.6%) in the group with additional autoimmune disease was statistically significantly elevated than the group without autoimmune disease (19.9%) (p=0.016). The rate of subclinical hypothyroidism was statistically significantly elevated in the group without additional autoimmune disease (p<0.001). A statistically significant relationship was found between elevated Anti-Tg and additional autoimmune disease (OR=2.32 (95% CI; 1.16–4.56). The prevalence of additional autoimmune disease was increased 2.32 times in patients with elevated anti-Tg levels.There was no statistically significant correlation between the sex of the patients, their thyroid function status and thyroid autoantibodies (p=0.507). However, the prevalence of celiac disease was statistically significantly elevated in female patients (43.5%) than in male patients (6.7%) (p=0.014). In addition, the prevalence of T1DM was found to be statistically significantly elevated in males (93.8%) compared to females (52.2%) (p=0.007). 13.3% of patients with additional autoimmune disease were under the age of 10 and 64.4% were above the age of 10, this was statistically significant (p<0.01). T1DM was the most common autoimmune disease in both groups.CONCLUSION: As shown in our study, autoimmune diseases, especially T1DM and celiac disease, are associated with HT. It should be kept in mind that there is an increased risk of autoimmune disease in HT that affects both sexes and increases with age. In particular, regular follow-up of HT patients with elevated anti-Tg levels in terms of autoimmune disease development is important in terms of earlier diagnosis of diseases and reducing their morbidity.

The influence of thyroid pathology on the course of periodontal disease in children and ways to correct it (Review)

Iodine deficiency diseases constitute an important medical and social problem, since a significant part of the territory of Ukraine is characterized by biogeochemical indicators of low iodine content in the environment, which is the cause of hypothyroidism development. At the same time, there are many other factors that can trigger the thyroid disorders in children. Epidemiological studies carried out in the Carpathian region have shown that iodine deficiency of varying degrees is specific to this area. Professor M.M. Kovalev's in-depth study of the causes of goitre in Bukovyna showed that along with iodine deficiency, macro- and micronutrient deficiencies associated with certain regions play an important role. Iodine deficiency promotes goitrogenesis and decreases the secretory capacity of the thyroid gland. As a result of reduced intrathyroid iodine in the gland, diiodothyrosine synthesis decreases and monoiodothyrosine increases, the hormone ratio increases due to an increase in the more biologically active triiodothyronine. This compensates for the euthyroid state against the background iodine deficiency. An adaptive manifestation of iodine deficiency is goitre, considered being the main sign of iodine deficiency; as iodine deficiency or thyroid hormone requirements increase, goiter size increases and more severe forms of thyroopathology develop. Iodine deficiency is common in many countries of the world. The analysis of the research data has shown the multifactorial nature of the etiology and pathogenesis of periodontal diseases in children, as well as the significant impact of thyroid disorders on the condition of the human dentition. In this regard, the study of cause-effect relationships between the initial manifestations of thyroid pathology and periodontal tissue changes in children seems relevant and promising in terms of improving methods of diagnosis, prevention and treatment. Keywords: periodontium, diffuse non-toxic goitre, children.

Clinical, biochemical, and radiological follow-up results of children and adolescents with Hashimoto's thyroiditis: a single-center experience.

Hashimoto's thyroiditis (HT) is the most common cause of goiter and acquired hypothyroidism in children and adolescents, especially in areas without endemic iodine deficiency. We aimed to evaluate the follow-up results of children and adolescents diagnosed with HT, including clinical, biochemical, and radiological findings and treatment approaches. HT patients, who were diagnosed between 2012 and 2018 years in a single-center, were assessed retrospectively. Two hundred and twenty-four cases were included in the study, 75.9% of whom were girls (female/male ratio: 3.1) and 66.5% were pubertal. The median age of the cases at first admission was 12.5 (9.2-15) years. The median follow-up period of 196 patients, who continued their follow-up regularly, was 2.1 (0.7-4.8) years. When autoantibody levels were analyzed according to gender, mean anti-Tg levels were higher in girls (p=0.028), whereas anti-TPO levels were similar (p=0.372). A nodule was detected in the ultrasonographic follow-up of 29 (13%) patients. Papillary thyroid carcinoma was observed in 10.3% (n=3) of those with nodules. When the last ultrasonography findings of 188 patients with available radiological follow-up data were compared with their initial evaluation, the rate ofheterogeneous parenchymal echogenicity increased significantly (p=0.008). The need for l-thyroxine dosage augmented over time. Although HT is more common in adolescent girls, it can be encountered in both genders and at all ages in childhood. The incidence of malignancy was not higher in patients with nodules associated with HT than the reported incidences of malignancy in nodules not associated with HT.

Hashimoto Tiroiditinin Çocuklarda ve Ergenlerde Geriye Dönük Analizi: Tek Merkez Deneyimi

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.

Adıyaman ilinde guatrla başvuran çocuk hastalarda etiyolojik dağılım ile klinik ve laboratuvar özellikler

Aim: The most common cause of goiter in developed countries is autoimmune diseases, while the most common cause in developing countries is iodine deficiency. We aimed to evaluate the clinical and laboratory results and etiological and demographic characteristics of cases presenting with goiter. Materials and Methods: Seventy-five patients aged between 5 and 17 years presenting with goiter between October 2016 and January 2019 were included in the study. Results: 90.7% (68) of children with goiter were female and 9.3% (7) male, the rate of goiter being 9.7-fold higher among girls. In terms of etiology, 43 patients (57.3%) were diagnosed with iodine deficiency, 25 (33.3%) with Hashimoto’s thyroiditis (HT), five with Graves’ disease (6.7%), and two (2.7%) with thyroid hormone resistance (THR). Mean ages were 13.7±2.1 years in the iodine deficient cases, 13.7±2.7 in the HT group, 14.3±1.4 in the Graves’ disease patients, and 8.2±2.3 in the patients with THR. The highest mean urinary iodine level among iodine deficient patients was 45±27.1 (12.10-84.13) μg/L in Adıyaman center, while the lowest value was determined in Gerger district at 16.8±3.1 (14.27-20.25) μg/L, and 11 patients were diagnosed with mild iodine deficiency, 20 with moderate deficiency, and 12 with severe deficiency. Conclusion: Iodine deficiency was the most common cause of goiter in children in the province of Adıyaman, followed by autoimmune thyroid gland diseases such as Graves’ disease and HT. This study shows that iodine deficiency remains still as a problem in our province.

Histopathological examination of thyroid specimens - a single center study from Peshawar, Khyber Pakhtunkhwa

Introduction: Thyroid gland enlargement is a surgical problem that affects about a third of the world's adults. Thyroid enlargement is best diagnosed by histopathology of surgical specimen and can also give a clue about different pattern of diseases that include simple goiter, multinodular goiter, thyroiditis, adenoma, and last but not the least, carcinoma.
 Objective: To determine presentation of thyroid lesions based on their histopathology in patients presenting to Rehman Medical Institute (RMI), Peshawar from August 2018 to July 2019.
 Materials & Methods: This was a descriptive cross-sectional study, inclusive of all thyroid specimens, irrespective of age and gender, received in the Department of Pathology, Rehman Medical Institute (RMI), Peshawar, from August 2018 to July 2019. Data were retrieved and analyzed for descriptive statistics in MS Excel.
 Results: A total of 64 samples were collected; 56(87.5%) were non-neoplastic lesions while 08(12.5%) were neoplastic. 40(71%) multi nodular goiters, 11(19.64%) simple nodular goiter, 01(1.7%) case of Hashimoto’s thyroiditis, among neoplastic 04(50%) were found to be papillary carcinoma and 02(25%) each were follicular and medullary carcinoma. Female to male ratio was 5:3 or 1.67:1 in neoplastic lesions.
 Conclusion: The most common cause of goiter was multinodular goiter. Among the neoplastic lesions, follicular adenoma was the commonest, while papillary carcinoma was the most common malignant lesions.
 Keywords: Multinodular goiter, follicular adenoma, Papillary carcinoma, Fine needle aspiration cytology.

Goiter Prevalence and Thyroid Autoimmunity in School Children of Delhi.

Introduction:Several studies from India, performed prior to 2010, have reported a goiter prevalence of greater than five per cent in school going children. There has been considerable success in universal salt iodization efforts in the past decade. We studied the prevalence of goiter and thyroid autoimmunity in school going children in Delhi between 2010 and 2014 to assess the impact of salt iodization.Materials and Methods:The study employed the population proportionate to size (PPS) cluster sampling methodology to select subjects between the age of six and 14 years, from all 34 wards of 9 districts of Delhi. Cluster randomization sampling design was followed and in this way we identified 30 wards, from each of which 90 children were recruited for the study. The total sample size was 2700 children. Estimation of fT3, fT4, TSH, anti-TPO antibodies and urine iodine concentration (UIC) was done for 10% of the study population.Results:The prevalence of goiter in this study in the 6–14 years age group was 6.4%. The prevalence of goiter was higher in females (7.7% compared to 5.3% in males, P = 0.01). In the 270 subjects who were selected for biochemical evaluation, subclinical hypothyroidism was seen in 18.4% and positive anti-TPO antibodies were seen in 14.8%. The median UIC was 150 μg/L.Conclusions:There is improvement in goiter prevalence in the post-iodization period in Delhi. But still, residual goiter rates are above five per cent suggesting presence of other causes of goiter in this area. There is a high prevalence of thyroid autoimmunity in this population.

A rare cause of goiter

A rare cause of goiter

Evaluation and management of the child with hypothyroidism.

Thyroid hormones are critical for early neurocognitive development as well as growth and development throughout childhood. Prompt recognition and treatment of hypothyroidism is, therefore, of utmost importance to optimize physical and neurodevelopmental outcomes. A PubMed search was completed in Clinical Queries using the key terms "hypothyroidism". Hypothyroidism may be present at birth (congenital hypothyroidism) or develop later in life (acquired hypothyroidism). Thyroid dysgenesis and dyshormonogenesis account for approximately 85% and 15% of permanent cases of congenital primary hypothyroidism, respectively. More than 95% of infants with congenital hypothyroidism have few, if any, clinical manifestations of hypothyroidism. Newborn screening programs allow early detection of congenital hypothyroidism. In developed countries, Hashimoto thyroiditis is the most common cause of goiter and acquired hypothyroidism in children and adolescents. Globally, iodine deficiency associated with goiter is the most common cause of hypothyroidism. Central hypothyroidism is uncommon and may be associated with other congenital syndromes and deficiencies of other pituitary hormones. Familiarity of the clinical features would allow prompt diagnosis and institution of treatment. To optimize neurocognitive outcome in infants with congenital hypothyroidism, treatment with levothyroxine should be started as soon as possible, preferably within the first 2weeks of life. Children with acquired hypothyroidism should also be treated early to ensure normal growth and development as well as cognitive outcome. The target is to keep serum TSH < 5mIU/L and to maintain serum free T4 or total T4 within the upper half of the age-specific reference range, with elimination of all symptoms and signs of hypothyroidism.

Assessment of psychiatric disorders accompanying Hashimoto's thyroiditis in children and adolescents

Objective: Hashimoto’s thyroiditis is the most common cause of goiter and acquired hypothyroidism in children and adolescents in non-iodine-deficient areas. In our study, it is aimed to determine the psychiatric disorders accom-panying Hashimoto’s thyroiditis which is a chronic disease in children and adolescents. Methods: In order to form the research group, 65 cases who were followed up and treated due to the diagnosis of Hashimoto’s thyroiditis in the Pediatric Endocrinology Department of the Trakya University Medicine Faculty were included in the study. In order to form the control group, 65 patients who were evaluated in the General Pediatrics Outpatient Clinic of the Pediatrics Department of Trakya University Medicine Faculty and did not have the chronic medical and neurodev-elopmental diseases were include in the study. In the child and adolescent psychiatry outpatient clinic, the Socio-demographic Data Form, the Strengths and Difficulties Questionnaire, Turgay’s Scale and the Schedule for Affective Disorders and Schizophrenia for School Age Children were applied to the cases in the research and control groups. Results: 38.4% of the cases with Hashimoto’s thyroiditis were diagnosed with at least one psychiatric disorder. In our study, the most frequent comorbid psychiatric disorder in children with Hashimoto’s thyroiditis was found as Specific phobia with rate of 20%. Specific phobia is followed by attention deficit hyperactivity disorder and depres-sive disorder with rate of 9.2%. In our study, there were no significant differences between patients with Hashimoto’s thyroiditis and healthy volunteers in terms of the attention deficit, hyperactivity, impulsivity, and oppositional defiant disorder. There was no significant difference between the cases with Hashimoto’s thyroiditis and the control group in terms of sensation, behavioral, attention deficit and mobility, peer relationships, social behavior and total difficul-ties scores. Discussion: When we evaluate the findings of our study, it can be considered that there was no any adverse effects of Hashimoto’s thyroiditis on the children's psychical status. However, due to being the limited num-ber of studies about this subject in the literature, it is necessary to support our findings with other studies conducted about this subject.

Knowledge and practices regarding use of iodised salt among population ofselected goitre endemic districts of Bihar

Background:Iodine deficiency disorders (IDDs) are important public health problem which can be prevented by consumption of iodized salt. For sustainable elimination of IDDs, the goal of universal salt iodization (USI) is to cover more than 90% of household to consume adequately iodized salt. This study was conducted with objectives to assess knowledge and practices regarding salt consumption and to find the factors associated with consumption of adequately iodized salt in selected districts of traditional goitre belt of Bihar. Materials and Methods: The study was a community based cross-sectional study conducted in three districts of Bihar by using cluster sampling technique from January 2018 to March 2018. Results: Only 1.7% children and 33% adults were able to identify the condition of goitre. Among adults who identified the case as goitre, around 52% respondents had correct knowledge about cause of goitre. Around 30% caregivers knew the brand name of salt that was used in their household and only 19% of adults had heard about iodized salt.In around 13% households; salt was added at the end of cooking during food preparation. Adequately iodized salt was consumed in 73.5% households. The salt stored in air tight container had significantly higher iodine content in comparison to salt stored in open container (p=0.041). Conclusion: The knowledge among people regarding IDDs and iodized salt was very poor which need to be focused in our national programme. The goal of USI regarding iodized salt consumption is yet to be achieved in these districts.

Hypothyroidism in Clinical Practice

Hypothyroidism in Clinical Practice

Hashimoto's disease in a cohort of 29 children and adolescents. Epidemiology, clinical course, and comorbidities in the short and long term.

Hashimoto's thyroiditis is the most common cause of goiter and hypothyroidism among children and adolescents. Its clinical manifestations and course vary. The objective of this study was to review the clinical and evolutionary characteristics of Hashimoto's disease in the pediatric population. Clinical, analytical, ultrasound, epidemiological, and evolutionary data of patients with autoimmune thyroiditis seen at Hospital Universitario San Juan de Alicante between January 2010 and January 2016 were analyzed. A total of 29 patients were included in the study. A higher prevalence of girls was observed, at a 2:1 ratio. The main reason for consultation was the accidental detection of high thyroid stimulating hormone levels or positive anti-thyroid antibodies in a lab test done for other reason. In the initial analysis, 53.3% of patients had subclinical hypothyroidism and only 10% of them had frank hypothyroidism. Two patients developed thyroid cancer.