Profile of thyroid disorders in a referral centre in north India.

ABSTRACT

From 1983-88, 157 patients were investigated in our clinic for thyroid disorders 117 (75%) were hypothyroid, 10 (6%)-hyperthyroid, and 30 had euthyroid goiters. Average age of presentation of congenital hypothyroids was 4.07 years. Children with goitrous hypothyroidism (n = 19) were divided into (i) thyroiditis RAIU low and patchy, TMA positive 2 children; (ii) dyshormonogenesis RAIU high, family history positive, perchlorate discharge test positive 2 children; (iii) iodine deficiency RAIU high, urinary iodine low 2 children, and (iv) cause unknown RAIU normal or high, other investigations normal 13 children. Ninety eight hypothyroid children without goiter were divided into 6 groups (i) athyreosis RAIU low, no thyroid tissue identifiable (n = 39); (ii) hypoplasia RAIU low, gland small, in normal position (n = 7); (iii) ectopia RAIU low, gland in ectopic position (n = 24); (iv) thyroiditis TMA positive (n = 2); (v) iodine deficiency low urinary iodine (n = 1); and (vi) cause unknown RAIU and scan normal, other investigations normal and not done (n = 8). Proportionate short stature was present in 44.4% children. Twenty two children presented only with growth failure; 72% of them had dysgenetic glands. Early onset marked the group with hyperthyroidism (n = 10). Euthyroid goiter was present in 30 (19%). Hypothyroidism is still being diagnosed very late. All children with growth failure, even if proportionate, must have thyroid status evaluated.