ESPE Abstracts (2019) 92 P3-253

Child Thyrotoxicosis Syndrome: Structure and Characteristics

Evgeniya Evsyukova1, Irina Kolomina1, Sergey Bukin1, Elena Kisileva2, Oleg Latyshev2, Goar Okminyan2, Lyubov Samsonova2

1Z.A. Bashlyaeva Children's Hospital, Moscow, Russian Federation. 2Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation

Objective: To study the structure and characteristics of child thyrotoxicosis syndrome.

Materials and Methods: At the 1st stage, medical records of patients treated at the Endocrinology Unit of the Children's Hospital named after Z.A. Bashlyaeva of the City of Moscow in 2014-2018 (n=4530) were analyzed. At the 2nd stage, a primary examination of 106 children 3 to 17 years old with a diagnosis of thyrotoxicosis syndrome was performed. Serum TSH, free T4, free T4, anti-thyroglobulin, -thyroid peroxidase and -TSH receptor antibodies were analyzed in all patients; ultrasound examination of thyroid gland as well as thyroid gland scintigraphy (n=4) and molecular genetic PCR assay with direct sequencing (n=2) were performed as well. Immunological criterion of Graves disease was defined as anti-TSH antibodies values > 1.75 IU/mL.

Results: Thyrotoxicosis syndrome accounted for 2,3% in the structure of endocrine diseases in children. All the cases were presented with an overt clinical form of the disease. Thyrotoxicosis syndrome was significantly more frequently diagnosed in girls (81,1%) as compared to boys (18.9%, P=0.000) and was more frequent in teenagers (85,8%) as compared to prepubertate age children (14.2%, P=0.000).

Immunogenic forms of thyrotoxicosis syndrome in children were diagnosed in 94,3% of the cases and were represented by Graves disease (87,8 %) and thyrotoxicosis phase of autoimmune thyroiditis (6,6%, P=0.000).

Non-immune forms of thyrotoxicosis were significantly less frequent, 5.6% (P=0.000) and were represented by the following nosologies: single-node toxic goiter – 1.9% (2/106), iodine-induced thyrotoxicosis – 0.9% (1/106), multinodular toxic goiter in 0.9% (1/106), thyrotoxicosis due to TSHR gene activating mutation in 0.9% (1/106), drug-induced thyrotoxicosis in 0.9% (1/106).

Conclusion: The structure of thyrotoxicosis syndrome is heterogeneous, including both immune and non-immune forms; this should be kept in mind when considering the diagnostic work-up plan and the choice of the treatment strategy.

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