近年来儿童缺碘性甲状腺功能减退症:重新出现的问题?

IF 0.7 Q4 ENDOCRINOLOGY & METABOLISM
Tejal Patel, Rachel Longendyke, Roopa Kanakatti Shankar, Nadia Merchant
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引用次数: 0

摘要

摘要:由于非碘盐的新趋势,碘营养在美国成为一个日益严重的问题。目前还没有关于美国儿童缺碘性甲状腺功能减退症现状的最新综述。我们在我们的三级儿科内分泌诊所进行了一次回顾性病历审查,有四名患者符合碘缺乏的诊断标准,即尿碘水平低。我们进一步分析了疾病的严重程度、风险因素、甲状腺肿、甲状腺实验室检查和抗体。所有病例都有明显的甲状腺肿大,而且都是在最近两年内确诊的。其中一例患者因未摄入碘盐而缺碘,同时还被诊断为发育迟缓和多种食物过敏,而其他患者则使用了非碘盐。两个病例在缺碘的同时还伴有自身免疫。对所有甲状腺肿和/或甲状腺功能减退症患者进行饮食病史调查至关重要。可能需要考虑重新评估当前的碘缺乏症预防措施,尤其是针对某些弱势群体,如不食用加碘盐的儿童:近几十年来,由于饮食模式和食品生产方式的改变,碘营养问题日益受到关注。对于患有甲状腺功能减退症和甲状腺肿大的儿童,尤其是因行为问题、发育迟缓或多种食物过敏而限制饮食的儿童,了解其饮食史至关重要。在市面上销售的12种不同类型的盐中,只有食盐含有适量的碘;因此,使用特种盐的人可能会患上轻度至中度缺碘相关的甲状腺疾病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Iodine deficiency hypothyroidism in children in recent years: a re-emerging issue?

Summary: Iodine nutrition is a growing issue within the USA due to newer trends of non-iodized salts. There are no recent reviews looking at the current state of iodine deficiency-induced hypothyroidism in children in the USA. We performed a retrospective chart review at our tertiary pediatric endocrine clinic; four met the diagnostic criteria for iodine deficiency defined by a low urine iodine level. We further characterized severity of disease, risk factors, goiter, thyroid labs and antibodies. All cases had significant goiter and were diagnosed within the last 2 years. One case had iodine deficiency due to no iodized salt intake along with concurrent diagnosis of developmental delay and multiple food allergies, while others involved the use of non-iodized salts. Two cases had iodine deficiency along with autoimmunity. It is critical to obtain a dietary history for all patients who present with goiter and/or hypothyroidism. There may be a need to consider reevaluating current preventative measures for iodine deficiency, especially for certain vulnerable populations such as children who do not consume iodized salt.

Learning points: In recent decades, iodine nutrition has become a growing concern due to changing dietary patterns and food manufacturing practices. A dietary history is crucial to obtain in children presenting with hypothyroidism and goiter, especially in children with restrictive diets due to behavioral concerns, developmental delays, or multiple food allergies. Of the 12 different types of salts commercially available, only table salt contains iodine in an appropriate amount; thus, individuals using specialty salts can develop mild to moderate iodine deficiency-related thyroid disease.

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来源期刊
CiteScore
1.50
自引率
0.00%
发文量
142
审稿时长
9 weeks
期刊介绍: Endocrinology, Diabetes & Metabolism Case Reports publishes case reports on common and rare conditions in all areas of clinical endocrinology, diabetes and metabolism. Articles should include clear learning points which readers can use to inform medical education or clinical practice. The types of cases of interest to Endocrinology, Diabetes & Metabolism Case Reports include: -Insight into disease pathogenesis or mechanism of therapy - Novel diagnostic procedure - Novel treatment - Unique/unexpected symptoms or presentations of a disease - New disease or syndrome: presentations/diagnosis/management - Unusual effects of medical treatment - Error in diagnosis/pitfalls and caveats
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