儿童严重自身免疫性甲状腺功能减退症发病时的临床表现因诊断时间而异:是在SARS-CoV-2大流行之前还是期间。

Q3 Medicine
Jessica Munarin, Gerdi Tuli
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引用次数: 0

摘要

简介由于难以获得医疗服务,有关COVID-19对儿童甲状腺疾病表现的影响的数据很少:研究目的:评估COVID-19大流行之前和期间甲状腺功能减退症发病情况的差异:对2017年1月至2022年12月期间确诊的所有自身免疫性甲状腺功能减退症(AIT)儿科患者进行分析:共纳入150名受试者(大流行前94名,大流行期间56名)。大流行前和大流行期间分别有7.4%和12.5%的人被检测出患有严重的AIT。大流行前的发病年龄较低(P = 0.04)。大流行前和大流行期间两组的诊断延迟(从发病到诊断的时间)有显著差异(P = 0.02)。大流行前的 TSH 值为 447.7 ±59.1 mUI/l,大流行期间为 713.7 ±104.4 mUI/l(P = 0.04),而 fT4 平均值分别为 2.66 ±0.34 ng/l 和 0.58 ±0.08 ng/l(P = 0.0002)。在大流行期间,甲状腺体积和骨龄延迟 SDS 显著增大 ( p = 0.04)。大流行期间观察到的神经系统症状居多,尤其是言语迟缓和学习成绩受损:结论:大流行期间观察到的严重 AIT 发病率较高,这主要与难以获得医疗服务有关。诊断延迟导致甲状腺激素生化指标和甲状腺肿更为严重,发病时出现骨龄延迟和神经系统症状的频率更高。认识到甲状腺功能减退症并回忆起儿童时期的症状(即使往往是非特异性症状)是避免诊断延误的基础。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Differences in the clinical picture at the onset of diagnosis of severe autoimmune hypothyroidism in children depending on the time of diagnosis: before or during the SARS-CoV-2 pandemic.

Introduction: There are few data about effects of COVID-19 on thyroid disease presentation in children, due to difficulties in healthcare services access.

Aim of the study: To assess the differences in hypothyroidism presentation before and during the COVID-19 pandemic.

Material and methods: All paediatric patients with autoimmune hypothyroidism (AIT) diagnosed from January 2017 to December 2022 were analysed.

Results: A total of 150 subjects were enrolled (94 in before and 56 during the pandemic period). Severe AIT was detected in 7.4% before and 12.5% during the pandemic. Age at the onset in the pre-pandemic period was lower ( p = 0.04). Diagnosis delay (time elapsed from onset of symptoms and diagnosis) was significantly different between the before and during the pandemic groups ( p = 0.02). In the pre-pandemic period the TSH value was 447.7 ±59.1, and it was 713.7 ±104.4 mUI/l during the pandemic ( p = 0.04), whereas mean fT4 values were 2.66 ±0.34 and 0.58 ±0.08 ng/l, respectively ( p = 0.0002). Significantly greater thyroid volume and bone age delay SDS were observed during the pandemic ( p = 0.04). Neurological symptoms were mostly observed during the pandemic, especially slow speech and impaired school performance.

Conclusions: A higher rate of severe AIT was observed during the pandemic period, mostly related to difficulties in access to healthcare services. The diagnosis delay led to a more severe biochemical thyroid hormone profile, goitre, and more frequent presence of bone age delay and neurological symptoms at the onset. Recognizing hypothyroidism and recalling symptoms in child-hood, even if often non-specific, is fundamental for avoiding diagnosis delay.

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来源期刊
Pediatric Endocrinology, Diabetes and Metabolism
Pediatric Endocrinology, Diabetes and Metabolism Medicine-Pediatrics, Perinatology and Child Health
CiteScore
2.00
自引率
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发文量
36
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