The results of ultrasound examination of the thyroid gland in children with hypothyroidism

Diseases of thyroid gland (TG) rank first among all endocrine pathologies and remain one of the most difficult problems. According to the statistics of Ministry of Health of Ukraine, the prevalence of hypothyroidism in children does not exceed 0.035%. However, the relatively low rate can be explained by the low level of detection and diagnosis of this pathological condition due to the variability and low specificity of its symptoms. More acceptable for practice are methods of ultrasound diagnosis of the thyroid gland and laboratory examination of the content of thyroid-stimulating hormone in the serum. Aim. To evaluate the results of ultrasound examination of the thyroid gland in children with hypothyroidism. Methods. The results are based on a survey of 94 children with hypothyroidism living in the Chernivtsi region aged 2 to 10 years. An ultrasound examination of the thyroid gland, determination of the level of thyroid hormones (thyroid stimulating hormone (TSH), free thyroxine (fT4) was performed. Statistical analysis was performed using standard methods using the StatSoft software package © Statistica® 6.0 for Microsoft® Windows XP. Results. Analysis of the results of the study showed that in 59.6% of cases (56 out of 94) the diagnosis was made by screening for congenital hypothyroidism, and in 40.4% of cases (38 out of 94) the disease was diagnosed outside the screening. According to the results of our ultrasound, it was found that in 29 patients the thyroid tissue was not visualized in a typical place or its total volume was much less than normal. Of these, in 12 individuals, thyroid tissue was not reliably visualized at the site of TG projection, and in 17 cases was hypoplasia. In 65 patients, the TG was in a typical place, and its volume corresponded to the norm on the surface area of the body. In 85 people, regardless of the state of functional activity of the TG had a heterogeneous echostructure of the thyroid parenchyma), in 9 people the echostructure of the thyroid parenchyma was homogeneous. In thyroid hypoplasia, the level of TSH was at lower values (p <0.05) compared with thyroid dystopia. Conclusion. Sonographic examination of the thyroid gland has a high level of information. In cases of malformations of the thyroid gland there is a more pronounced degree of thyroid insufficiency

Indicators of cognitive activity of children with laboratory hypothyroidism

The growth rate of a healthy child, the peculiarities of its physical and intellectual development, the formation of reproductive function are largely determined by the state of the endocrine system. Thyroid hormones have a significant impact on the growth and development of the child's organism. Today, attention is focused on the consequences of intellectual disabilities in children with hypothyroidism, as well as the impact of chronic iodine deficiency in the environment on the development of children. Insufficient intake of iodine in the body leads to congenital dysontogenesis of higher mental functions, to the formation, in severe cases, of mental retardation of varying degrees, and, in mild forms - to the borderline or partial disorders of intelligence. The aim is to study the cognitive functions of children with laboratory hypothyroidism. Methods. For a screening study of the intellectual development of school-age children living in geographical areas of Chernivtsi region (Ukraine) with varying degrees of iodine supply, 399 schoolchildren aged 11-18 years were studied, including 194 boys and 205 girls. The main group consisted of children (99) with laboratory hypothyroidism (HL), with thyroid stimulating hormone (TSH) elevation or with diverse complaints and who had been found to have elevated TSH levels during routine examinations. Patients with any kind of systemic disease and/or taking medications were excluded from the study. Diagnosis of HL was based on mild increase of TSH (5-25mIU/L) with a normal fT4 level. Thyrotropin-releasing hormone (TRH) test was also performed in all children. TSH response to TRH stimulation was considered to be normal when TSH levels were between 5-25 mIU/L. The formation of intellectual function was determined using a fragment of the R. Kettel test (adapted modified version of the children's personality questionnaire R. Kettel). Іnclusion сriteria: age 11-18 years, living in the Chernivtsi region, the absence of organic pathology of the CNS and mental retardation, diseases of the eyesight and hearing, for 6 months, all subjects did not receive any treatment with iodine-containing drugs and thyroid hormones. Results. Analysis of the study results showed that children, for the most part, have an average degree of intellectual development (60%). The level of intellectual formation changed in the direction of decreasing with increasing degree of iodine deficiency. Among children with laboratory hypothyroidism, the number of those who had a low level of intelligence was almost twice as high as in children from the comparison group 25 [21.8-27.3] % against 13 [11.8-16.6] %, P < 0.01). Children with laboratory hypothyroidism have a "debt" of 56% of attention, 36% of perception, 26% of motility, and 44% of memory. The pace of operating activities was reduced by 26%. Comparison of TSH concentration, ioduria and thyroid volume with the presence or absence of deficits in certain cognitive functions showed that in children with laboratory hypothyroidism and fine motor skills TSH G level was increased by 90%, thyroid volume by 28% , and with memory loss - 125% and 38%, respectively. Correlative analysis revealed a highly probable positive relationship between moderate strength in prepubertal children between thyroid volume and fine motor skills (r = 0.485, P < 0.01), memory (r = 0.488, P < 0.05) and efficiency (r = 0,321, P < 0,05). Conclusion. Children with subclinical hypothyroidism are characterized by decreased memory, instability of attention and decreased ability to concentrate, impaired fine motor skills, which generally reduces their mental capacity

Marker profile of digestive system organs comorbid pathology in children

The article highlights the current state of the comorbid pathology of the digestive system problem in children. Attention is paid to the most significant trigger factors of comorbid pathology of the digestive system organs in children and they are given a prognostic assessment with the development of a mathematical model of developmental risk.Aim. To identify predictors of comorbid pathology of the digestive system in children and to determine their prognostic value.Material and methods. 115 children with comorbid pathology of the digestive system organs and 80 healthy children aged 7-18 years were examined. The state of biological, social and genealogical well-being was determined by means of questionnaires. Laboratory and instrumental studies were conducted in accordance to the Ministry of Health ofUkraineorders in the specialty "Pediatric Gastroenterology" with the informed consent of patients to participate in the study.Results. Etiologically determining risk factors for the development of comorbid pathology of the digestive system organs in children are unfavorable genealogical history with hereditary burden by both pedigrees, age and sex of the child, H. pylori infection, stress, vitamin D3 and iodine deficiency, endothelial dysfunction, disruptions of regional blood flow in the abdominal trunk, premorbid background.Conclusion. It is established that the risk of comorbid pathology of the digestive system in children will increase by 4.27 times if the child has identified by us non-modifying factors, and by 2.62 times under the influence of modifying factors

Indicators of cognitive activity of children with laboratory hypothyroidism

Abstract. The growth rate of a healthy child, the peculiarities of its physical and intellectual development, the formation of reproductive function are largely determined by the state of the endocrine system. Thyroid hormones have a significant impact on the growth and development of the child's organism. Today, attention is focused on the consequences of intellectual disabilities in children with hypothyroidism, as well as the impact of chronic iodine deficiency in the environment on the development of children. Insufficient intake of iodine in the body leads to congenital dysontogenesis of higher mental functions, to the formation, in severe cases, of mental retardation of varying degrees, and, in mild forms – to the borderline or partial disorders of intelligence