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ORIGINAL ARTICLE
Year : 2015  |  Volume : 12  |  Issue : 1  |  Page : 14-22

Evaluation of etiology, clinical profile and management outcomes in juvenile hypo and hyperthyroidism: A single centre experience


1 Department of Endocrinology, Osmania General Hospital, Hyderabad, India
2 Department of Endocrinology and Consultant Endocrinologist, Elite Endocrinology Clinic, Hyderabad, Andhra Pradesh, India

Correspondence Address:
Dr. J Venkateswarlu
Flat no-204, Sai Sree Apartment, Sivaji Nagar 2nd Lane, Mangamurudonka, Ongole, Andhra Pradesh - 523 002
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-0354.147280

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Objective: The aim of this study was to evaluate the etiology, clinical profile and response to treatment in physical, sexual and psychological aspects in juvenile hypo and hyperthyroidism. Materials and Methods: 63 patients of newly diagnosed overt hypothyroidism (TSH > 15μIU/ml and T4 < 5.5μg/dl) and 5 patients of hyperthyroidism (TSH < 0.1μIU/ml and T4 > 12μg/dl) in 8-16 years age group presenting with various symptoms are followed for 1-2 years after starting treatment with levothyroxine/carbimazole. Dose was adjusted to maintain TSH/T4 in normal range. The response to treatment is monitored by physical, sexual and intellectual parameters. Results: Among 68 patients, 63 (92.6%) are overt hypothyroid and 5 (7.4%) are hyperthyroid. The age group included was 8-16 years. Among hypothyroid patients, puberty was attained within a year of treatment in patients with delayed puberty. There was improvement in cognitive function with treatment though statistically not significant. Positive TPO antibodies was associated with low T4 and high TSH (P < 0.05). Among hyperthyroid group (5 patients), chief complaints are goitre in 100%, weigt loss in 100% and proptosis in 60% (3 patients). Sexual maturity was appropriate for age Bone age was appropriate for chronological age. There was no significant difference in cognitive function with treatment. Conclusion: In juvenile age group, most common cause for hypothyroidism is Hashimotos thyroiditis and hyperthyroidism is Graves disease. Goitre and growth retardation are commonest mode of presentation of both hypo and hyperthyroidism.TPO antibodies is associated with severe hypothyroidism (low T4 and high TSH). Even hyperthyroid children presents with poor height gain. Height velocity and sexual maturity improve with treatment. Cognitive function was not significantly affected in hypo or hyperthyroidism.


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