ALTERACIONES TIROIDEAS EN NIÑOS Y ADOLESCENTES DIABETICOS INSULINODEPENDIENTES

GRUÑEIRO PAPENDIECK, L; CHIESA, A.; TRIFONE, L; BERGADÁ, I; RAIZMAN, H; BERGADA, C

Acta Pediátrica Española

Ediciones Mayo

Lugar: Madrid; Año: 1995

Insulin-dependent diabetic children often have thyroid disorders, but the incidence varies from one series to another. We studied autoimmune thyroid disease (AITD) in 107 Argentine diabetic children and adolescents (66 girls, 41 boys) between 4.6 and 20 years of age. Serum T4, T3, TSH and/or TSH response to TRH, and thyroid antimicrosomal antibodies (AMA) were measured at diagnosis or during follow-up. AMA were found in 37.3% of patients, goiter in 52.8% and thyroid dysfunction in 24.3% (hypothyroidism in 21.5% and hyperthyroidism in 2.8%). Hypothyroidism occurred in 20/23 patients following the onset of IDDM, wbereas hyperthyroidism preceded the appearance of IDDM. A positive family history of autoimmune disease (IDDM type I or thyroid disease) was present in 20.6% of the group as a whole and in 40.9% of hypothyroid patients. The measurement of autoantibody titers for the identification of subjects with thyroid dysfunction was seen to have a sensitivity of 76%, specificity of 76%, a positive predictive value of 50% and a negative predictive value of 90%. We recommend initial screening by measuring thyroid antibodies and TSH levels and periodical evaluation of the thyroid function in those patients with a high risk profile.