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57th Annual ESPE

Athens, Greece
27 Sep 2018 - 29 Sep 2018

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ESPE 2018 57th European Society for Paediatric Endocrinology Annual Meeting 27-29 September 2018 Athens, Greece

hrp0089p3-p361 | Thyroid P3 | ESPE2018

Prevalence and Demographic Profile of Thyroid Disorders in Indian Children

Sethi Aashish , Ramachandran Smita , Kochar Inderpal

Introduction: Thyroid hormone abnormalities are the commonest endocrine disorder in India and also the commonest preventable cause of mental retardation.Aim: To determine the prevalence, clinical profile, etiology and associated co-morbidities of thyroid dysfunction in children.Materials and Methods: This is a retrospective study, performed in our tertiary care Pediatric Endocrine Center at Indraprastha Apollo Hospital, Delhi, Indi...

hrp0089p3-p362 | Thyroid P3 | ESPE2018

Graves’ Disease in a Pediatric Population: Results from the Last 17 Years at a Pediatric Endocrinology Unit

Carvalho Fabia , Paredes Silvia , Miguel Gomes Maria , Martins Sofia , Marques Olinda , Antunes Ana

Introduction: Graves’ disease (GD), the main cause of hyperthyroidism in children, is caused by thyrotropin receptor stimulating autoantibodies (TRABs) that activate thyroid hormone synthesis, secretion and thyroid growth. Therapeutic options are anti-thyroid drugs (ATD), 131-I or thyroidectomy. This study reports the experience of a Tertiary Pediatric Endocrinology Unit.Methods: Review of GD patients diagnosed from January/2001 to October/2017. Res...

hrp0089p3-p363 | Thyroid P3 | ESPE2018

Acquired Severe Hypothyroidism in Children – Forgotten or Unbelievable Diagnosis in a Time of Large and Easy Availability of Thyroid Tests?

Kucharska Anna , Labochka Dominika , Borowiec Ada , Witkowska- Sedek Ewelina , Pyrzak Beata

In a time of widespread availability of thyroid lab tests plenty of patients are reported to endocrine clinics because of isolated slightly increased TSH value and many papers are dedicated disscussion of precautions to treatment in subclinical hypothyroidism. Simultaneously in the same places other patients develop severe hypothyroidism without proper diagnosis. What is the reason of missing diagnoses?The Aim: Clinical characteristics of severe hypothyr...

hrp0089p3-p364 | Thyroid P3 | ESPE2018

Thyroid Disorders and Autoimmunity in Children and Adolescents with Type 1 (T1DM) and Type 2 Diabetes Mellitus (T2DM)

Soliman Ashraf , Alyafei Fawzia , Alkhalaf Fawziya , Sabt Amal , Waseef Reem , Aldarsy Nagwa

Hypothyroidism is prevalent among pediatric patients with T1DM and is associated with a more aggressive form of the disease. Patients with T1DM and hypothyroidism have higher rates of DKA, develop the disease at younger ages, and require higher insulin doses. T2DM patients are also more prone to thyroid disorders. The prevalence of thyroid dysfunction in adults with T2DM patients was reported to be 12.3% in Greece and 16% in Saudi Arabia and has been reported to be associated ...

hrp0089p3-p365 | Thyroid P3 | ESPE2018

The Reference and Follow-up Signs and Symptoms of the Cases Who Are Diagnosed As Hyperthyroidism

Gokce Demir Elif , Guven Ayla , Yildiz Metin

Objective: Hyperthyroidism is rarely seen in the childhood. In this study, we evaluated the reference sign and symptoms and following laboratory and treatment results of the hyperthyroidism cases.Method: Data of the 78 patients were extracted from hospital records retrospectively. Patients’ height, weight, BMI and laboratory results at the time of diagnosis are recorded. Antithyroid drug doses at the 2th, 6th, 12th months after diagnoses are compare...

hrp0089p3-p366 | Thyroid P3 | ESPE2018

Clinical Features in Childhood Graves’ Disease

Kılınc Uğurlu Aylin , Doğer Esra , Demet Akbaş Emine , Bideci Aysun , Camurdan Orhun , Cinaz Peyami

Introduction: Hyperthyroidism is a disorder of the thyroid function in childhood that causes symptoms such as low school performance, headache, hyperactivity, palpitation, systolic hypertension, heat intolerance, diarrhea, weight loss inspite of tremendous appetite and tremor. Hyperthyroidism is very rare in childhood. Graves’ disease is responsible for 84% of pediatric cases and is the most common cause.Method: The demographic characteristics, refe...

hrp0089p3-p367 | Thyroid P3 | ESPE2018

General Characteristics of Autoimmune Thyroid Diseases and Evaluation of Accompanied Morbiditis

Burcu Palandokenlier İbili Aysel , Selver Eklioğlu Beray , Emre Atabek Mehmet

Aim: Thyroid hormones are necessary for neurological and psychological well-being in addition to normal growth and development in children and adolescents. Hashimoto thyroiditis is the most common cause of goiter and acquired hypothyroidism and Graves’ disease is the main cause of hyperthyroidism in children and adolescents. These two diseases are evaluated in the group of autoimmune thyroid diseases and will be evaluated because of their frequent occurrence in childhood ...

hrp0089p3-p368 | Thyroid P3 | ESPE2018

Amiodarone Induced Hyperthyroidism in a Pediatric Patient

Marques Bernardo , Oliveira Sofia , Laranjo Sergio , Lopes Lurdes

Introduction: Thyroid dysfunction is the most common side effect of amiodarone therapy, ranging from subclinical changes to overt clinical thyrotoxicosis (AIT) and/or hypothyroidism (AIH). Two major types of AIT have been described: type I usually develops in multinodular goiter or in preexisting Graves’ disease where an overload of iodine is responsible for the overproduction of thyroid hormones, and type II presents as a destructive thyroiditis, with release of pre-form...

hrp0089p3-p369 | Thyroid P3 | ESPE2018

Abstract withdrawn....

hrp0089p3-p370 | Thyroid P3 | ESPE2018

Thyroid Carcinoma in Children: 7 Years’ Experience of a Single Center

Preda Cristina , Ciobanu Gabriela Delia , Ungureanu Maria-Christina , Leustean Letitia Elena , Teodoriu Laura , Balaceanu Raluca , Grigorovici Alexandru

Introduction: Thyroid cancer is the most common pediatric endocrine cancer, constituting 0.5%–3% of all childhood malignancies. Cancer can be present in multinodular thyroid disease but the majority of malignant nodules are solitary. Thyroid malignancies in children are almost always well differentiated.Aim: Prevalence, clinical features, pathological profile and therapy of thyroid cancer in children.Patients and method: Retro...

hrp0089p3-p371 | Thyroid P3 | ESPE2018

Autoimmune Thyroiditis (Hashimoto Thyroiditis) in a Known Case of Autoimmune Hemolytic Anemia

fawzy Dina , Eliwa Nesreen

Background: Chronic, autoimmune thyroid diseases are sometimes combined with autoimmune hematologic diseases, such as pernicious anemia, autoimmune hemolytic anemia (AIHA) and idiopathic thrombocytopenic purpura (ITP). Hashimoto thyroiditis is one of the most common autoimmune diseases.Case report: seventeen years old female adolescent complaining of delayed puberty and short stature. She is a known case of autoimmune hemolytic anemia diagnosed at age of...

hrp0089p3-p372 | Thyroid P3 | ESPE2018

Dento - Maxillary and Periodontal Changes in Puberty/Adolescence in Subclinical Hypothyroidism of Autoimmune Cause

Circo Eduard , Gosu Cristina , Ibadula Seila , Circo Razvan

Introduction: The development of the dentomaxillary system in children involves a normal thyroid function. Juvenile hypothyroidism has different complications depending on the congenital or acquired nature of it.Objective: To identify periodontal changes under the conditions of chronic autoimmune thyroiditis and subclinical hypothyroidism.Material and method: The study group comprised 24 young patients, 15 girls and 9 boys (15.2&#1...

hrp0089p3-p373 | Thyroid P3 | ESPE2018

Hypovitaminosis D and Chronic Autoimmune Thyroiditis Mammary Echostructural Involvements in Puberty

Ibadula Seila , Circo Eduard

Introduction: Benign breast pathology has a frequent onset during puberty-adolescence.Objectives: Differential evaluation of breast echostructure in puberty stage III/V, on Tanner scale, depending on the presence of thyroid autoimmunity and hypovitaminosis D.Method: Assessment of BIRADS score from 2 to 4 in three groups of girls associating premenstrual mastodynia: Group 1 - including patients with chronic autoimmune thyroiditis an...

hrp0089p3-p374 | Thyroid P3 | ESPE2018

Two Contrasting Cases of Solitary Thyroid Nodules in Adolescent Girls

Walder Eleanor , Puthi Vijith

Introduction: Thyroid nodules are uncommon in the paediatric population, present in 5% of children but 35% of adults. However, up to 25% of paediatric nodules are malignant, compared to 5% in adults. It can be challenging to differentiate malignant nodularity from benign clinically, particularly in the presence of a thyroid disorder. We present two contrasting cases of adolescent girls with solitary thyroid nodules.Case 1: A 13-year-old girl was referred...

hrp0089p3-p375 | Thyroid P3 | ESPE2018

Congenital Hypothyroidism – Diagnose Early and Keep Going

Sergeyev Elena , Sloltze Anette , Kiess Wieland , Pfaeffle Roland , Koerner Antje

Background: Serious mental and physical retardation are sequelae of untreated congenital hypothyroidism. These complications have become rare since the introduction of neonatal screening in Germany.Case report: Here we report about a girl with congenital hypothyroidism, who suffered from extreme short and thickset stature, rough facial features and straw-like hair at the age of 12 years. She had been detected in newborn screening with a TSH of 132 IU/ml....

hrp0089p3-p376 | Thyroid P3 | ESPE2018

An Impressive Recovery of Arrested Growth and Puberty in a 13 Year Old Boy after Being Treated for Simultaneously Diagnosed Severe Hypothyroidism and Coeliac Disease

Fafoula Olga , Panagouli Eleni , Panagiotakou Argyro , Mpeni Maria , Georgila Chrisitina , Korovessi Paraskevi , Kostaridou Stauroula

Background: Individuals with celiac disease are more likely to develop autoimmune thyroid disease compare to the general population and vice versa. Undiagnosed in childhood and adolescence, both diseases compromise final height. Clinical experience shows that near complete catch-up growth is possible in infants and young children, but not in children near or in puberty.Objectives: To report on the impressive acceleration of arrested growth in a 13 year o...

hrp0089p3-p377 | Thyroid P3 | ESPE2018

A Very Rare Thyroid Hormone Resistance Case Having Heterozygous Mutation in THRB Genes

Keskin Mehmet , Yılmaz Seniha Kiremitci , Kaplan Emel Hatun Aytac , Karaoğlan Murat , Karaer Kadri , Keskin Ozlem

Objective: Thyroid hormone resistance is a rare autosomal dominant disease. In the pathogenesis of this disease mutations have been reported in two types of thyroid hormone receptors, called alpha and beta. Deletions or mutations in cofactors required to demonstrate receptor effect also reported in the beta receptor gene. The symptoms vary according to the cases. Here; a case of thyroid hormone resistance which is noticed by chance and not treated is presented.<p class="ab...

hrp0089p3-p378 | Thyroid P3 | ESPE2018

Clinical Case (Children’s Endocrinology)

Strauhmane Ieva , Zvigule - Neidere Gunda , Kravale Ieva , dzivite-Krisane Iveta , Kaze Inita

Clinical case: 05.11.2017 – On the visit of endocrinologist came 16-year-old girl arrives on an outpatient visit to evaluate and treat post-operative hypothyroidism. The patient has complaints about periodic pain in the neck of the scar area. From an anamnesis it is known that in December 2016, a patient was diagnosed thyroid papillary carcinoma at stage T1b. 07.12.2016. extirpation of total right thyroid lobe on is complete, after receiving a histological answer on March...

hrp0089p3-p379 | Thyroid P3 | ESPE2018

Thyroid Imaging Study for the Diagnosis of Congenital Hypothyroidism with Thyroid Dysgenesis

Chun Sangwoo , Yu Jeesuk

Background: Primary congenital hypothyroidism can be classified into thyroid dysgenesis and thyroid dyshormonogenesis. Thyroid dysgenesis includes aplasia, hypoplasia, and ectopia. About one-third of ectopic thyroid is presented with congenital hypothyroidism, but sometimes it may be difficult to diagnose ectopic thyroid in infancy. Thyroid ultrasonography or scintigraphy can be used to diagnose thyroid dysgenesis, but sometimes it is hard to diagnose correctly by using one of...

hrp0089p3-p380 | Thyroid P3 | ESPE2018

A Case of Permanent Congenital Hypothyroidism with Compound Heterozygous Mutations in the DUOX2 Gene

Hwang Jeongju , Jang Ja-Hyun , Yu Jeesuk

Introduction: Congenital hypothyroidism is defined as thyroid hormone deficiency present at birth. It is the most common congenital endocrine disorder. Neonatal screening test for hypothyroidism can allow its early detection. The course of disease can be permanent or transient. Some permanent congenital hypothyroidism has been linked to defects in proteins involved in the synthesis of thyroid hormones. One of the critical steps in the synthesis of thyroid hormone is the genera...

hrp0089p3-p381 | Thyroid P3 | ESPE2018

Growth Catch-up on Acquired Hypothyroidism Presenting with Growth Delay

Serra-Caetano Joana , Miranda Patricia , Ferraz Ana , Dias Ana Lopes , Lages Adriana , Cardoso Rita , Dinis Isabel , Mirante Alice

Introduction: Hypothyroidism is a frequent endocrinopathy in pediatric age. The most common manifestation in children is growth delay with decreased height velocity. Symptoms can be insidious and, if not identified ant treated, result in short stature.Aim: To evaluate stature catch-up after replacement therapy in children with primary acquired hypothyroidism.Methods: Retrospective study of all children with primary acquired hypothy...

hrp0089p3-p382 | Thyroid P3 | ESPE2018

Thyroid Disease in Children and Adolescences with Down Syndrome– 16 Years of Follow Up in a Single Service

Schmitt-Lobe Maria Claudia , Fogaca Hamilton , Scheidemantel Aline , Nepomuceno Mariel Correa

Introduction: It is well known that thyroid disease (TD) is more prevalent in patients with Down Syndrome (DS). Among the dysfunctions are congenital hypothyroidism (CH), subclinical hypothyroidism (SC-H), Hashimoto’s thyroiditis (HT) and Graves’ disease (GD).The evaluation of the occurrence of these diseases in patients with DS according to age is still poorly reported.Objective: Verify the prevalence of TD in children and adolescents with DS ...

hrp0089p3-p383 | Thyroid P3 | ESPE2018

Corticosteroid Resistant Immune Thrombocytopenic Purpura, is it a Marker of Future Graves Disease?

Azcona Maria Cristina , Leon Jose Luis , Prados Monica , Ochotorena Amaia , Oliver Asier

Introduction: The Immune Thrombocytopenic Purpura (ITP) and Graves Disease (GD) have in common an autoinmune physiopathology. ITP is characterized by a platelet count less than 100 × 106/l in the absence of other cause. On one hand, ITP has been associated with thyroid dysfunction, without developing GD. On the other hand, GD might develop with moderate thrombocytopenia, generally more than 100×109/l. It is described that in most cases ITP might...

hrp0089p3-p384 | Thyroid P3 | ESPE2018

Neonatal Hypothyroidism following Transplacental Amiodarone Treatment for Supraventricular Tachyarrhythmia

Korpal-Szczyrska Maria , Mysliwiec Malgorzata , Szczyrski Jozef

Background: The proper function of fetal thyroid gland depends on a proper content of iodine in mother’s diet and its transplacental transportation. Fetal iodine overload may be responsible for fetal hypothyroidism. Amiodarone is an iodine-rich antiarrhythmic medication and it contains 37% iodine by weight. Fetal tachyarrhythmia is associated with significant perinatal morbidity and mortality. If left untreated can cause congestive heart failure and non-immune hydrops fet...

hrp0089p3-p385 | Thyroid P3 | ESPE2018

Rare Case Report of Thyroiditis De Quervain in a Six Years Old Girl

Liapi Maria , Jorch Norbert , Hamelmann Eckard

Introduction: Subacute thyroiditis or De Quervain’s Thyroiditis is a self-limited inflammatory thyroid disease that is considered to be caused by a viral infection. Its incidence during the first decade of life is extremely rare. During the acute phase of the disease which lasts 2 to 6 weeks, the inflammatory process results in a temporary release of thyroid hormone with biochemical hyperthyroidism with or without symptoms. This phase is followed by a period with failing ...

hrp0089p3-p386 | Thyroid P3 | ESPE2018

Papillary Thyroid Carcinoma in a 7 Year Old Boy Presenting with a Goiter Without Microcalcifications and Enlarged Cervical Lymph Nodes

Becker Marianne , Vega Letizia , De Beaufort Carine , Philippe Paul , Kieffer Isabelle

Introduction: Only 1.8% of thyroid malignancies occur during childhood, explaining very limited pediatric data. Most frequent in children are papillary thyroid carcinoma (PTC), occurring after exposure to radiation, and presenting as a thyroid nodule ± cervical lymph nodes. PTC may present as diffusely infiltrating disease of the thyroid with microcalcifications. We report an uncommon presentation of a PTC in a 7 year old boy.Case report: The boy wa...

hrp0089p3-p387 | Thyroid P3 | ESPE2018

Graves’ Disease, Methimazole and SLE-like Reaction:A Case Report

Yafi Michael , Pillai Chanthu , Cox Charles

Background: Graves’ disease therapy in young children may be challenging due to lack of therapy options. The safety of Radioiodine Ablation (RIA) has not been proven in children under age of 10 years. Propylthioracil (PTU) therapy has been linked to hepatic failure and became contraindicated in pediatrics.The case: A 6-year-old female was diagnosed with Graves ‘disease and treated with Methimazole (MTZ) and Propranolol. A few days after startin...

hrp0089p3-p388 | Thyroid P3 | ESPE2018

A Rare Case of Pediatric Hyperthyroidism

Ciccone Sara , Ubertini Graziamaria , Pasini Manuela , Stella Marcello

Background: Hyperthyroidism is rare in childhood and adolescence and Graves’ disease accounts for approximately 96% of pediatric cases of thyrotoxicosis.Case Report: A 12-year-old girl, with no relevant family or personal history, was examinated for a thyroid mass noticed a few days before. She also reported excessive sweating of the hands and mild psychomotor agitation. Clinical examination revealed, in addition to the right thyroid mass, other sig...

hrp0089p3-p389 | Thyroid P3 | ESPE2018

Allan–Herndon–Dudley Syndrome in a Patient with Global Delay Development – a Case Report

Noorian Shahab

Introduction: Allan–Herndon–Dudley syndrome is a rare X-linked inherited disorder characterized by, axial hypotonia, weakness, and severe intellectual disability1 Allan-Herndon-Dudley syndrome is caused by mutations in the SLC16A2 gene (also known as MCT8) This gene is located on the chromosome Xq13.2, mutations of the SLC16A2 gene lead to impaired making a protein that transports thyroid hormone triiodothyronine (T3) into nerve cells, for this re...

hrp0089p3-p390 | Thyroid P3 | ESPE2018

Multi Autoimmune Phenomenon in Indian Children with Thyroid Disorder

Ramachandran Smita , Sethi Aashish , Kochar Inderpal

Objective: To evaluate the prevalence of autoantibodies associated with hypothyroid disease and to assess the associated comorbid autoimmune diseases in Indian pediatric patients.Materials and Methods: Children (n=373) diagnosed with hypothyroidism at Indraprastha Apollo Hospital, Delhi, India were screened for celiac disease (tissue transglutaminase autoantibodies [TTGAb]) which were further confirmed by upper GI endoscopy and biopsy for coelia...

hrp0089p3-p391 | Thyroid P3 | ESPE2018

Levothyroxine Treatment of Subclinical (SH) and Overt (OH) Hypothyroidism in Children with Autoimmune Hashimoto Thyroiditis (AHT): A Retrospective Study in Regard with TSH and Free T4 (FT4) at Diagnosis

Leka-EmirI Sofia , Petrou Vassilios , Evangelopoulou Cathrine , Kafetzi Maria , Fotinou Aspasia , Vlachopapadopoulou Elpis , Michalacos Stefanos

Objectives: Assess the dose of levothyroxine in relation to TSH and FT4 levels at diagnosis of AHT in children with SH and OH.Methods: Eighty eight children (69 girls) with AHT were devised in regard with TSH and FT4 at diagnosis [SH-FT4 >0.9 ng/dl: Group 1: TSH: 4.5-7 mU/l, Group 2: TSH: 7-10 mU/l, Group 3: TSH: >10 mU/l and OH: Group 4: TSH>10 mU/l and FT4 ≤0.9 ng/dl]. Mean L-T4 dose was reported in μgr/Kg per day at diagnosis an...

hrp0089p3-p392 | Thyroid P3 | ESPE2018

Hashitoxicosis:a Rare Diagnosis in Childhood

Vlachopapadopoulou Elpis Athina , Stergiotis Stefanos , Dikaiakou Eirini , Kafetzi Maria , Vakaki Marina , Fotinou Aspasia , Michalacos Stefanos

Aim: To highlight the diagnosis of Hashitoxicosis and its distinction from Graves’s disease. Subjects with Hashimoto’s thyroiditis are often euthyroid or may experience subclinical or true hypothyroidism. However, in 5 to 10% of children, a transient phase of hyperthyroidism, called Hashitoxicosis, may occur.Patients-Methods: Three female patients, were referred at the ages of 61/12, 96/12 and 12...

hrp0089p3-p393 | Thyroid P3 | ESPE2018

An Assay Led Astray: A Curious Case of Biotin-Induced Hyperthyroidism

Taylor-Miller Tashunka , Alexander Ashely , Yen Tina , O'Connell Michele

The third child to Burmese parents is born at term in good condition in a suburban hospital. The baby was breast fed from birth and had a normal physical examination without dysmorphic features or palpable liver edge. The parents have had two previous live male births at term, that developed severe jaundice and seizure in the first 24 hours of life; both passed away on day 3 of life. Due to concerns of possible metabolic condition, the baby was commenced on prophylactic photot...

hrp0089p3-p394 | Thyroid P3 | ESPE2018

A Case of Steroid-Responsive Encephalopathy Associated with Autoimmune Thyroiditis (SREAT) in a Girl with Newly Diagnosed Hashimoto Thyroiditis

Lim Yijuan Yvonne , Sng Anjian Andrew , Ho Cindy Wei-li , Lee Yung-Seng , Loke Kah-Yin

Background: SREAT is a rare entity in children, with about 60 cases described to date. It is characterised by acute encephalopathy, elevated anti-thyroid antibodies and exclusion of other causes of encephalopathy like infection, tumour, toxic or metabolic diseases. Typical presentations in children include behaviour changes, psychosis and seizures. The role of anti-thyroid antibodies in the pathogenesis is not clearly understood, and the titre level does not predict severity o...

hrp0089p3-p395 | Thyroid P3 | ESPE2018

Intellectual Outcome at Childhood in Congenital Hypothyroidism According to Etiology and Treatment Related Factors

Hong Yong Hee

Introduction: The intellectual outcome in children with congenital hypothyroidism detected by neonatal screening is generally good. The aim of this study was to evaluate the intellectual outcome in patients with congenital hypothyroidism at childhood and to identify factors that may affect intellectual development.Methods: The intelligence quotient (IQ) of 126 patients with congenital hypothyroidism was evaluated at childhood using the Korean Wechsler In...

hrp0089p3-p396 | Thyroid P3 | ESPE2018

Myastenia Gravis in a Girl with Hashimoto Thyroiditis

Gucev Zoran , Alili Laerta , Laban Nevenka , Tasic Velibor

Objective: To describe an association of Hashimoto’s thyroiditis and myasthenia gravis in a 16 years old girl.Patient Report and Methods: A 18-year old girl with persistent hypothyroidism secondary to Hashimoto’s thyroiditis and a family history of Hashimoto’s thyroiditis (grandmother), diagnosed in 2005 and confirmed by elevation of thyroid stimulating hormone (TSH), low levels of T3, T4 and fT4 levels. The US of the thyroid gland reveale...

hrp0089p3-p397 | Thyroid P3 | ESPE2018

Head Circumference, Birth Length, and Weight of Neonates of Mothers with Hypothyroidism

Laron-Kenet Tamar , Silbergeld Aviva , Lilos Pearl , Laron Zvi

Background: The number of publication on head size of newborns of hypothyroid mothers is scant.Aim: To study concomitantly head circumference, birth length and weight in such neonates.Method: Data was retrieved from computerized medical records of our hospital.Results: One hundred and thirty nine neonates (82 males and 57 females) from a total of 18,538 deliveries at the Rabin Medical Center during the years ...