Clinical characteristics of children and adolescents with thyroid disorders seen at the University of Port Harcourt Teaching Hospital: A five year review

Abstract

Background: Thyroid disorders constitute a large proportion of endocrine diseases in children and adolescents. Diseases of the thyroid have profound effect on metabolism, cognition, growth and development in children. The pattern of thyroid disorders in children in our region is still under reported.
Objectives: To describe the clinical characteristics of children and adolescents with thyroid diseases seen over a 5 year period in a tertiary
centre in Port Harcourt
Methods: A retrospective review of all cases of thyroid disorders seen in the Paediatric endocrinology clinic of the University of Port Harcourt Teaching Hospital from January 2009 to December 2013.The information obtained
from endocrine registers and case files were patients’ biodata, clinical features, diagnosis, management, challenges and outcome. Diagnosis
of each disorder was based on clinical features, relevant laboratory
investigations and imaging studies.
Result: Eighteen (29.3%) out of 62 children with various endocrine disorders had thyroid diseases, accounting for 0.1% of all children
seen in the specialist outpatient clinics. Age range at presentation
of children reported was 5days to 13 years with male to female ratio
1.7:1. Of the 18 children, 5(27.8%) had hyperthyroidism with a case of neonatal thyrotoxicosis, 10(55.6%) hypothyroidism and 3(16.7%) euthyroidism. eight (44.4%) had goiter. Nine (90.0%) of the children with hypothyroidism had congenital hypothyroidism with two cases of transient
hypothyroidism. Mean age at diagnosis of children with congenital hypothyroidism was 9.81months. Only 2(22.2%) with congenital hypothyroidism presented before the age of 3weeks, the mean duration
of neck swelling before presentation of children with goitre was 19.6months. One (5.6%) child had thyroid cancer. Initial wrong referrals and lost to follow up in 22.2% of cases each were common challenges encountered in management.
Conclusion: Congenital hypothyroidism was the commonest thyroid disorder in this report, delayed diagnosis and its consequences were noted, emphasizing the need for routine new-born screening in Nigeria.

Keywords: Thyroid disorders, children, endocrine diseases, antithyroid treatment