ESPE Abstracts

Background and aims: To explore the functional autonomy in adolescents with nodular goitre.

Materials and methods: We have examined 66 patients with nodular goiter from iodine deficient region. There were 48 girls (mean age 14.91±1.78 years) and 18 boys (mean age 14.46±2.75 years) among them. Uninodular goitre was diagnosed in 43 patients, 23 patients had multinodular goitre. The survey included thyroid scintigraphy 99mTc and assessment of the functional state of the pituitary-thyroid system: TSH, fT₄, fT₃. Reference values of TSH were detected as 0.4–4.3 mkEd/ml, fT₄ 9–20 pmol/l, and fT₃ 4.4–9.3 pmol/l.

Results: Based on the results of scintigraphy of thyroid gland ‘hot’ nodules were diagnosed in 31 of 66 (47%) adolescents. ‘Hot’ nodules met with equal frequency in girls (27 of 48) and boys (four out of 18, P=0.129) with nodular thyroid disease. There were 14 of 43 (33%), 12 girls/two boys with ‘hot’ nodules among patients with uninodular goitre, and 17 of 23 (74%) of patients (15 girls/two boys) in cases of multinodular goiter. Among patients with ‘hot’ nodules the ten (32%) adolescents had thyrotoxicosis. The number of nodules didn’t influence on functional state of the thyroid gland (P=0.075). So, thyrotoxicosis was found in eight (57%) patients (seven girls/one boy) with ‘hot’ uninodular goitre. Half of them produced symptomatic thyrotoxicosis (the mean values of TSH 0.24±0.44 mkED/ml, fT₃ 13.44±2.01 pmol/l, fT₄ 22.4±2.67 pmol/l) and half–subclinical (the mean values of TSH 0.059±0.1 mkED/ml, fT₃ 4.77±0.95 pmol/l, fT₄ 13.26±2.1 pmol/l). Among patients with multinodular goiter with ‘hot’ nodules, two of them (12%) had subclinical thyrotoxicosis (average values of TSH 0.2±0.27 mkEd/ml, fT₃ 4.34±1.02 pmol/l, fT₄ 11.85±0.64 pmol/l).

Conclusion: The results of the study have shown that every second adolescent with nodular thyroid disease from iodine deficient region has a ‘hot’ nodule, more than that, each third of them produces decompensation of autonomous thyroid function. That underlines the role of scintigraphy in adolescents with nodular thyroid disease.