ESPE2016 Poster Presentations Thyroid P2 (49 abstracts)
Belorussian State University of Medicine, Minsk, Belarus
Suitably treatment of Basedow–Graves’ disease (BGD) provide the minimization of time to develop the medicamental remission. Research: determine clinical, laboratory particularities, evaluate efficiency of pharmaceutical treatment of BGD in children in different age groups. Materials and methods: 35 children with BGD were examined (4 boys, 31 girls): 1st group (Tanner 1) n=4, 7.5±0.65 years; 2nd – (Tanner 2–4) n=22, 12.32±0.31 years; 3rd – (Tanner 5) n=9, 15.56±0.24 years. Data of laboratory research (free thyroxine (FT4); TSH; thyroid peroxidase antibodyies (TPOAb); TSH receptor antibodies (TRAb)), thyroid gland’s ultrasound were analysed. Methods of variation statistics were used in statistical processing of results.
Results: Increase of thyroid gland was marked in children with BGD in manifestation: 1st – 172.75±19.52%, 2nd – 169.59±13.2%, 3rd – 117.74±6.89%, P<0.05. Elevation of FT4 levels (pmol/l) (1st – 95.51±27.61, 2nd – 57.9±5.97, 3rd – 71.94±22.57; n 10.0–23.2; P<0.05), TPOAb (ME/ml) (1st – 168.75±78.89, 2nd – 477.79±105.25, 3rd – 827.57±178.3; n<30; P<0.05), TRAb (ME/ml) (1st – 15.65±2.5, 2nd – 18.47±1.28, 3rd – 12.53±0.61; n<4; P<0.05), decrease TSH values (uME/ml) (1st – 0.03±0.01, 2nd – 0.04±0.01, 3rd – 0.03±0.01; n 0.25–5.0; P<0.05) were revealed in manifestation. Block-regimen treatment was used. Initial dose of antithyroid drug (Thiamazole) (mg/kg per day): 1st – 0.86±0.06, 2nd – 0.55±0.05, 3rd – 0.43±0.04, P<0.05. Maintenance dose of Thiamazole (mg/kg per day): 1st – 0.22±0.04, 2nd – 0.19±0.02, 3rd – 0.12±0.02, P<0.05. Duration of treatment (years): 1st – 3.25±0.85, 2nd – 2.89±0.32, 3rd – 1.33±0.24, P<0.05. Control values of FT4 in remission (pmol/l) (1st – 13.33±1.68, 2nd – 15.32±3.34, 3rd – 15.58±1.25, P<0.05), TSH (uME/ml) (1st – 3.75±0.98, 2nd – 3.32±0.64, 3rd – 2.6±0.68, P<0.05), TPOAb (ME/ml) (1st – 1.4±0.21, 2nd – 2.26±0.16, 3rd – 2.36±0.4, P<0.05). Negative correlation between patient’s age and Thiamazole dose was found (r=−0.39, P<0.05). Conclusions: more higher doses of antithyroid drug were used in the period of manifestation and medication remission of disease in prepubertal children compared to patients with Tanner 2–5; longer term of pharmaceutical treatment need to prepubertal children’s recovery comparison to pubertal aged patients.