study of goiter among female adolescents referred to centre for nuclear medicine, Lahore

ABSTRACT

To study goiter and thyroid dysfunction in female adolescents residing in Lahore referred to Centre for Nuclear Medicine [CENUM], Mayo Hospital for thyroid scanning and thyroid function tests. Design: Retrospective study of thyroid size, thyroid scan patterns and serum FT, and TSH levels. Setting: Centre for Nuclear Medicine [CENUM], Mayo Hospital, Lahore Patients 350 female adolescent referred during September 2002 to April 2003. Main outcome measures: adolescent goiter, thyroid nodules, hyperthyroidism, hypothyroidism, Graves' disease, toxic multinodular goiter. Among 350 adolescents 212[60.6%] had goiter of various grades mostly visible. Among goiterous patients 136[64.2%] had diffuse and 76 [35.8%] had nodular presentation. The number of patients with solitary nodular goiter [20.7%] was more than multinodular goiter [15.1%] and number of patients with solitary cold nodule [16.5%] was more than functioning nodule [4.2%]. The incidence of biochemical thyroid dysfunction, both overt and subclinical, was detected in 42[19.8%] patients and was significantly more frequent in patients with nodular than diffuse presentation [29% VS 14.7%; p<0.001] and in multinodular than solitary nodular goiter [p<0.005]. More than 80% of the patients with solitary nodular goiter were euthyroid. Simple goiter was detected in 116[54.7%], Graves' disease in 5[2.4%] and toxic multinodular goitre in 4[1.9%] patients. Overall incidence of hypothyroidism was more than double as compared to hyperthyroidism. Incidence of nodularity and hypothyroidism was more in large goiter but duration of goiter was not significant in promoting nodularity. Goiterous adolescents need urgent attention because they don't have just diffuse hypertro- phy with normal thyroid function. Many are afflicted with dysfunction and nodularity, particularly solitary cold nodule bearing risk of thyroid malignancy