ABSTRACT
In Nigeria, thyroid disorders in childhood and adolescence have not been sufficiently studied. Where studies are available, they were either conducted decades ago or they involved only adults. The objectives are to describe the pattern of thyroid disorders among children and adolescents seen in a Nigerian teaching hospital and highlight the management challenges encountered. In this retrospective study, the case notes of all the children and adolescents with thyroid disorders seen in the Paediatric Endocrine-Metabolic Clinic and of those admitted into the wards of the University of Benin Teaching Hospital (UBTH) from 2005 to 2011 were audited. The total number of cases seen at the paediatric clinics of the Department of Child Health, UBTH was derived from the clinic attendance register of the department. Of the 8,350 cases seen during the period, 9(0.11%) had thyroid disorders, representing one per 930 cases. Of the 9 patients with thyroid disorders, 6(66.7%) had hyperthyroidism, 2(22.2%) had nongoitrous hypothyroidism and one (11.1%) had euthyroid goiter. The overall mean age at presentation for thyroid disorders was 11.2±4.3 years (95% Confidence Interval, CI = 8.4-14.0) and female-to-male ratio was 4:1. For the patients with hyperthyroidism, the mean age of presentation was 12.8±3.1 years (95% CI= 10.3-15.3) and female-to-male ratio was 5:1. The two children (a boy and a girl) with nongoitrous hypothyroidism were aged 3.5 and 6.0 years respectively. The mean duration of symptoms before presentation was thyroid disorders 1.72±1.2 years (95% CI=0.94-2.50), hyperthyroidism 8.5±1.5 months (95% CI=7.3-9.7). The only case of euthyroid goiter (female) presented at the age of 14 years. The two children with nongoitrous hypothyroidism had florid signs of hypothyroidism, such as growth retardation, mental retardation and delayed developmental milestones at presentation. A high clinic default rate was observed. Hyperthyroidism was the most common form of thyroid disorder observed and patients with thyroid disorders tended to present late.