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58th Annual ESPE (ESPE 2019)

Vienna, Austria
19 Sep 2019 - 21 Sep 2019

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The theme of this year’s meeting is Variety and Variation in Paediatric Endocrinology. Join us in Vienna to explore the diversity we encounter in our discipline and the care that we have to exercise when using the term “normality”. Whilst gaining an update on the latest treatments, clinical best practice and cutting edge research in the field of paediatric endocrinology.

hrp0092p2-276 | Thyroid | ESPE2019

Novel Thyroid Hormone Receptor β-Gene Mutations in Resistance to Thyroid Hormone

Kim Heung Sik , Kim Se Jin , Kim Ga Hyun , Kang Seok Jin

The syndrome of resistance to thyroid hormone (RTH) is caused by decreased tissue responsiveness to thyroid hormone. With the exception, inheritance of RTH is autosomal dominant. The receptors are encoded by two genes (THRA and THRB), each of which undergoes alternate splicing to generate receptor subtypes (TRa1, TRβ1, and TRβ2), with differing tissue distributions.Here we describe a child with novel heterozygous mutations for THRB. Nine-months-old ...

hrp0092p2-277 | Thyroid | ESPE2019

Congenital Hypothyroidism: Neonatal SCREENING PROGRAM with T4 and TSH

Chueca Maria J. , Moreno Paula , Dura Teodoro , Berrade Sara , Andres Carlos , Garcia Maria Dolores , Moreno Jose Carlos , Ascunce Nieves

Objectives: -To determine children diagnosed with central congenital hypothyroidism (CCH) by a screening program using TSH and total T4 between May 2016 and January 2019.-To analyze the characteristics of the disease in these children.Material and Methods: During the time of the study, 14.743 newborns have been screened. Cut-off points are used for TSH ≥10MU/ml and T4 6 and 20 mg/dl as lower ...

hrp0092p2-278 | Thyroid | ESPE2019

A 10- Year-Old Girl with Thyroid Hormone Resistance (βTHR)- Case Report

Bossowski Artur , Michalak Justyna , Sawicka Beata , Sanczyk Hanna Borysewicz- , Kolanowska Monika , Kubiak Anna , Jazdzewski Krystian

Introduction: Thyroid hormone resistance (THR) is a rare syndrome which is characterized by reduced response to thyroid hormones at tissue level. The disorder is caused by genetic mutation in the thyroid hormone receptor. The most common are a heterozygous thyroid hormone β (THRβ) gene mutations. Laboratory tests usually show normal or elevated level of thyroid- stimulating hormone (TSH) and high concentration of thyroid hormones (T3 and T4).<p c...

hrp0092p2-279 | Thyroid | ESPE2019

Diagnosis of Central Congenital Hypothyroidism and Multiple Pituitary Deficiencies Through a Neonatal Screening Program

Grau Gema , Concepción Fernández María , Artola Elena , Sarasua Ainhoa , Lizarralde Eneritz , Pintos Carla , Vela Amaia , Rodríguez Amaia , Díez Ignacio , Rica Itxaso

The congenital central hypothyroidism (CCH) incidence is estimated at 1:18,000-30,000 neonates and most are included in multiple pituitary deficiencies (MPD). Clinical depend on the etiology, the deficit severity; other associated hormonal alterations and the age of diagnosis. Neonatal screening (NS) for congenital hypothyroidism that includes T4 facilitate its diagnosis.Objetives: •To evaluate the characteristics of patients with C...

hrp0092p2-280 | Thyroid | ESPE2019

Childhood Thyroid Cancer After Radi Oiodine Therapy

Baz Ouidad , Chelghoum Imane , Hasbellaoui Fella , Belabas Lynda , Khalifa Anissa , Ziani Z , Chahboune Ahmed , Mimouni Zerguini Safia

Introduction: Differenciated thyroid cancer (DTC) is a rare disease in children and adolescents, it concerns approximatively 1.4% of all pediatric malignancies. Papillary thyroid carcinoma (PTC) is the most common subtype of DTC in pediatric as well as in adult with necessity of radio iodine therapy after surgery.Aim: The aim of our study is to evaluate follow up after iodine therapy in childhood patients treated for...

hrp0092p2-281 | Thyroid | ESPE2019

Differential Diagnosis of Euthyroid Hyperthyroxinemia

Globa Eugenia , Zelinska Nataliya , Hirschfeldova Katerina , Schevchenko Iryna , Lebl Jan , Hana Vaclav

Introduction: The pathology of thyroid gland is Ukraine is quite common and in 2018y included 277,708 patients with diffuse goiter (36.47 per 1000 population), 2,311 patients (0.30:1000) with nodular goiter, 341 patients with diffuse toxic goiter (0.04:1000), 7,157 (0.94:1000) with autoimmune thyroid disease and 129 patients with thyroid cancer (1.7:100000). However the syndrome of resistance to thyroid hormone (RTH) or Familial Dysalbuminemic Hyperthyroxinemi...

hrp0092p2-282 | Thyroid | ESPE2019

Treatment for Graves' Disease in Children and Adolescents: A Long-Term Retrospective Study at a Single Institution

Kim Min-Sun , Song Ari , Park Hyojung , Cho Sung Yoon , Jin Dong-Kyu

Background: Management options are limited for the treatment of Graves' disease (GD) in children and adolescents. Antithyroid drugs (ATDs) remain the first-line therapy in patients with GD, despite a high relapse rate. We investigated the clinical characteristics, treatment, the outcome, and predictors of a remission of children and adolescents with GD at a single center.Methods: We retrospectively reviewed the medic...

hrp0092p2-283 | Thyroid | ESPE2019

Changes of Thyroid Function in Girls with Central Precocious Puberty After 6-Month GnRH Agonist Treatment

Huh Rimm , Yoojin Chung Lindsey , Nam Hyo-Kyoung , Rhie Young-Jun , Lee Kee-Hyoung

Objectives: In our previous study, serum thyroid stimulating hormone (TSH) level in the central precocious puberty (CPP) group was higher than that of the non-CPP group. Serum free thyroxine (fT4) level in the CPP group was notably lower than that of the non-CPP group. And it was also showed that age and peak luteinizing hormone (LH) were independent predictors of serum TSH concentration. Elevated TSH in girls with CPP is supposed to be associated with puberta...

hrp0092p2-284 | Thyroid | ESPE2019

Papillary Thyroid Cancer Associated with Hyperthyroidism

Acar Sezer , Paketçi Ahu , Demir Korcan , Ates Oguz , Özer Erdener , Özdogan Özhan , Böber Ece , Abaci Ayhan

Introduction: The most common causes of hyperthyroidism in the pediatric age group are autoimmune conditions (Graves' disease or Hashitoxicosis). Hyperfunctioning thyroid carcinomas are rarely reported. In this case report, we present a 17-year-old girl who was diagnosed with papillary thyroid carcinoma upon testing for hyperthyroidism.Case: A 17-year-old girl had presented to another center with a 1-month history of...

hrp0092p2-285 | Thyroid | ESPE2019

Serum PTH Does not Correlate with Their Serum Calcium Levels in Children and Adolescents with Hashimoto Thyroiditis

Shima Hirohito , Sogi Chisumi , Umeki Ikumi , Suzuki Dai , Kamimura Miki , Saito-Hakoda Akiko , Kanno Junko , Kure Shigeo , Fujiwara Ikuma

Background: Hashimoto thyroiditis (HT) is characterized by autoimmune-mediated destruction of the thyroid gland. Ca metabolism disturbance due to hypoparathyroidism among HT patients remains to be clarified.Objective: To clarify the relationship between HT and primary hypoparathyroidism.Patients and Methods: Serum levels of Ca, albumin, and whole PTH (wPTH, ECLIA) were measured in ...

hrp0092p2-286 | Thyroid | ESPE2019

Management of Childhood Thyroid Nodules in Children a Large Group of Cases From a Single Center

Sieniawska Joanna , Makuch Magdalena , Mlodawska Anna , Maslowska Kamila , Krawczyk Sylwia , Kapczuk Iga , Ben-Skowronek Iwona

Background: Thyroid nodules are quite common in the adult population (13%)but are relatively rarely diagnosed in childhood (0.2-5%).There is a significantly higher risk of malignancy of paediatric thyroid nodules than that in adult patients. The authors of this publication present the observations of the occurrence, diagnosis, and treatment of patients with thyroid nodules in the Department of Pediatric Endocrinology and Diabetology, Medical University...

hrp0092p2-287 | Thyroid | ESPE2019

Bone Homeostasis in Children with Subclinical Hypothyroidism: Effects of Two-years Treatment with Levothyoxine

Barbieri Flavia , Esposito Andrea , D'Acunzo Ida , Lorello Paola , Di Mase Raffaella , Improda Nicola , Capalbo Donatella

Background: Thyroid hormone plays a key role in bone mineral homeostasis and significant alterations in its circulating levels have been associated with an impairment in skeletal growth during childhood. To date, the effects of subclinical hypothyroidism (SH) on bones have not been studied and the management of this condition is still debated.Aim: To evaluate bone mineral density (BMD) in children with mild, persistent S...

hrp0092p2-288 | Thyroid | ESPE2019

The Most Frequently Seen Reason of Congenital Hypothyroidism: Iodine Loading

Keskin Mehmet , Colak Berat , Kaplan Emel H.A. , Karaoglan Murat

Objective: Congenital hypothyroidism; currently, it is one of the most common causes of preventable mental retardation in children. Thyroid dysgenesis, thyroid hormone production and efficacy disorders or temporary hypothyroidism can be seen with the tables. In this study; The aim of this study was to evaluate the etiology and prognosis of congenital hypothyroid patients guided by national screening and neonatal centers. In this way; Our aim is to produce the ...

hrp0092p2-289 | Thyroid | ESPE2019

Uncommon Presentations of a Common Condition: Experience from a Teaching Hospital!

Ahmad Ayesha

Introduction: Hypothyroidism is one of the commonly diagnosed endocrinopathy in children. The typical manifestations of a hypofunctioning thyroid are lethargy, somnolence, dry skin, cold intolerance, constipation, weight gain and bradycardia along with faltering height. Hypothyroidism presenting with typical manifestations is therefore readily suspected and diagnosed. Occassionally, the patients might present with unsual clinical features which might mimic oth...

hrp0092p2-290 | Thyroid | ESPE2019

A Rare Combination- Brain Lung Thyroid Syndrome

Sandamal Sajith , Jauhari Praveen , Weerasinghe Kamal

A girl, who was born to non-consanguineous Afghan parents, was detected with high TSH on newborn blood spot screening. Her venous blood results had elevated TSH level (31.31mU/L), normal free T4 level (10.2pmol/L) and normal thyroglobulin. Isotope scan showed normal uptake and anatomically normal position of thyroid. L-thyroxin treatment was commenced soon. Since early life she had recurrent respiratory distress and recurrent chest infections needing prolonged oxygen therapy. ...

hrp0092p2-291 | Thyroid | ESPE2019

Investigation of Oxidative Effect in Saliva and Gingival Groove Fluids in Children with Hashimoto Thyroiditis

Atar Müge , Tan Aykut , Yetkin Ay Zuhal , Atar Müge , Pirgon Özgür

The aim of this study was to determine the periodontal health status in patients with Hashimoto thyroiditis (HT) and investigate the gingival groove fluid and saline oxidative stress parameters in order to demonstrate their relationship.Method: 30 patients between the ages of 11-17 years and 30 healthy volunteers aged between 10-17 years were included in the study. Serum tT4, TSH, anti-TPO, glucose, insulin, ALT, triglyceride, total chol...

hrp0092p2-292 | Thyroid | ESPE2019

Thyroid Autoimmunity in Children and Adolescents with Type 1 Diabetes Mellitus

Selveindran Nalini M , Wong SL Jeanne , Hong Janet YH , MZ Fuziah

Introduction: Type 1 diabetes mellitus (T1DM) is commonly associated with other organ – specific autoimmune disorders. Autoimmune thyroid disease (AITD) is the most common comorbid autoimmune condition in patients with T1DM. The occurrence of both T1DM and AITD is defined as Autoimmune Polyglandular Syndrome type 3 variant (APS3v). We sought to clarify thyroid autoimmunity in a cohort of Malaysian patients with T1DM.Methods<...

hrp0092p2-293 | Thyroid | ESPE2019

Analysis of Diabetes-Associated Autoantibodies in Children and Adolescents with Autoimmune Thyroid Diseases

Bossowski Artur , Rydzewska Marta , Michalak Justyna , Bossowska Anna , Chen Shu , Black Sarah , Powell Michael , Furmaniak Jadwiga , Smith Bernard Rees

Background: Zinc transporter 8 autoantibodies (ZnT8Abs) together with glutamic acid decarboxylase autoantibodies (GADAbs), insulinoma antigen 2 autoantibodies (IA-2Abs) and insulin autoantibodies (IAbs) are markers of type 1 diabetes mellitus (T1DM). We studied the prevalence of ZnT8Ab in children with autoimmune thyroid diseases (AITDs) to assess the association of AITDs and T1DM at the serological level.Methods: The st...

hrp0092p2-294 | Thyroid | ESPE2019

A New Case of Thyroid Hormone Resistance α Caused by a Mutation of THRA/TRa1

Chen Linqi , Sun Hui , Chen Xiuli , Chen Ting

The action of Thyroid hormone (T3) is mediated by the binding to nuclear receptors (TRa1, TRα1/2), which are ligand dependent transcription factors, encoded by the THRA and THRB genes. THRA germline mutations cause a rare genetic disease called resistance to thyroid hormone α (RTHα) first reported in 2012 . Only 20 missense and frameshift mutations have been reported to date, From this small group of patients, and analysis of animal models, it emerges that the d...

hrp0092p2-295 | Thyroid | ESPE2019

The Incidence of Congenital Hypothyroidism During the Neonatal Screening Program in the Republic of Karakalpakstan, Uzbekistan

Zhiemuratova Gulshad , Sharipova Madina , Rakhimova Gulnara

Background: In the world, the incidence of congenital hypothyroidism varies in wide ranges. In the neonatal screening based on thyroid-stimulating hormone (TSH), the optimal diagnostic level of TSH is essential to ensure that the true cases of congenital hypothyroidism are not missed.The goal was to compare the incidence rate of congenital hypothyroidism during the course of changes in the screening protocol for the periods of 2003-2007 ...

hrp0092p2-296 | Thyroid | ESPE2019

Progressive thyroid dysfunction in infants with Down Syndrome; Trisomy 21 (DS): Effect on Linear Growth

Alaaraj Nada , Soliman Ashraf , Mohammed Shayma , Itani Maya , Khalil Ahmed

Hypothyroidism is the most frequent thyroid abnormality in DS. It can be either congenital, with or acquired at any age after birth. It can be clinical or subclinical disorder. More evidence is required regarding the progressive development of thyroid dysfunction with age.Aim and Methods: We measured thyroid function (Free T4 and TSH) and Anti TPO level in 37 infants with DS at birth, during their first year and after ~ 2.5 years of...

hrp0092p2-297 | Thyroid | ESPE2019

Evaluation of Elevated Serum Thyroid-Stimulating Hormone (TSH) in Children and Adolescents: A Single-Center Study in Uruguay

Risso Mariana , Echeverría Gimena , Mendoza Beatriz

Introduction: Primary hypothyroidism is the most frequent thyroid disease in children, and elevation of serum TSH is a common presenting complaint (pc) in the pediatric endocrinology outpatient clinic. Subclinical hypothyroidism (sHT) predominates in relation to overt hypothyroidism (cHT). The benefit of Levothyroxine is controversial specially when serum TSH levels are less than 10 uUI/ml.Objectives: To evaluate the pre...

hrp0092p2-298 | Thyroid | ESPE2019

Neonatal Hyperthyroidism: Our Centre's Experience

Vigone Maria Cristina , Vincenzi Gaia , Caiulo Silvana , Di Frenna Marianna , Saracco Luca , Cecchetti Valeria , Mosca Fabio , Barera Graziano , Weber Giovanna

Objective: Neonatal hyperthyroidism is a severe but generally transient condition with a 2% prevalence in offspring of mothers affected by Graves' disease. It is caused by the transplacental passage of maternal anti-thyrotropin receptor stimulant antibodies (TRABs). Here we report the cases diagnosed at our centre between 2015-2019 in order to re-evaluate the diagnostic and therapeutic approach to this challenging neonatal thyroid alteration.<p cla...

hrp0092p2-299 | Thyroid | ESPE2019

Epidemiological Aspects of Pediatric Thyroid Disorders in Western Ukraine

Furdela Viktoriya , Pavlyshyn Halyna , Panichev Oleksandr , Sverstiuk Volodymyra

Introduction: Thyroid disorders (such as endemic and nodular goiter, thyroiditis, congenital and acquired hypothyroidism) are one of the most common endocrine problems in children and adolescents in Ternopil Region (Ukraine) during the last decades. The main causes of goiter in children may include autoimmune diseases and iodine deficiency.Purpose: The aim of current study is to assess goiter according to etiology in the...

hrp0092p2-300 | Thyroid | ESPE2019

The Encephalopathy as Complication of Hashimoto Thyroiditis in Children: A Wide Variety of Clinical Manifestations

Chiarello Paola , Talarico Valentina , Galati Maria Concetta , Raiola Giuseppe

Hashimoto encephalopathy is an autoimmune encephalopathy predominantly diagnosed in the adult population. In the pediatric population, the mean age is determined to be 14 years, with the majority of adolescent females. The diagnosis of Hashimoto encephalopathy is clinical and based on the highly variable neuropsychiatric conditions, often affecting more than one area of the central nervous system, the detection of antiperoxidase or antithyroglobulin antibodies in serum, and on...

hrp0092p2-301 | Thyroid | ESPE2019

Acute-Onset Peripheral Polyneuropathy in a 12-Year-Old Girl Due to Hashimoto Thyroiditis: Traps in the Diagnosis

Giza Styliani , Tychalas Athanasios , Gulordava Athina , Markidou Sophia , Litou Eleni , Kotanidou Eleni P , Rengina Tsinopoulou Vassiliki , Mouzaki Konstantina , Evangeliou Athanasios , Papadopoulou-Legbelou Kyriaki , Galli-Tsinopoulou Assimina

Introduction: Thyroid dysfunction may cause a wide range of neurological disorders in children. Hypothyroidism is associated with peripheral nerve demyelination. However, minimal data are available in pediatric population.Purpose: To describe a case of newly diagnosed Hashimoto thyroiditis (HT) suffering acute-onset rapidly progressive peripheral polyneuropathy.Case Report: A 12-ye...