Difficulties in diagnostics of polycystic ovary syndrome in adolescents - a preliminary study.

INTRODUCTION: Polycystic ovary syndrome (PCOS) accounts for 72-84% of adult hyperandrogenism, and in the majority of cases it begins during puberty. The diagnosis based on the Rotterdam criteria seem not to be efficient enough in adolescents. AIM OF THE STUDY: was the analysis of the frequency of PCOS according to Rotterdam criteria in adolescents. MATERIAL AND METHODS: Twenty-six girls with menstrual disorders and/or symptoms of hyperandrogenism two years after menarche were enrolled. We analysed medical history, clinical symptoms, pelvic ultrasound, and testosterone concentration (T). RESULTS: The study group was divided into three subgroups: with isolated cutaneous manifestation (CM) of hyperandrogenism (n = 6), with isolated menstrual disorders (MD; n = 10), and with cutaneous manifestation and menstrual disorders (CMMD; n = 10). We compared total T (cut-off points: > 42 ng/dl and > 55 ng/dl) and polycystic ovarian morphology (PCOM) occurrence. PCOM was detected in 54% of girls, with the highest proportion in the MD group (70%). Using a testosterone cut-off point of > 42 ng/dl, hyperandrogenaemia was confirmed in 81% with a preponderance of the CMMD group (90%). Eleven patients (42%) met all Rotterdam criteria. By more restrict-ed criteria with a testosterone cut-off point of > 55 ng/dl, hyperandrogenaemia was confirmed in 54% of patients, with the highest con-tribution in the CMMD group (70%), and seven patients (27%) met all Rotterdam criteria. Study did not show any correlation between T and ovarian volume (p = 0.695; Rs= 0.08). CONCLUSIONS: In our study 27% of patients suspected of PCOS met all Rotterdam criteria. The co-occurrence of symptoms increases the probability of hyperandrogenaemia.

Graves' disease in children in the two decades following implementation of an iodine prophylaxis programme.

Grave's disease (GD) is a form of thyroid autoimmune disease characterised by hyperthyroidism. It is a rare clinical problem in paediatrics. Development of disease is the result of genetic susceptibility and some environmental factors. One of the best-documented environmental factors involved in thyroid autoimmunity is iodine excess. The aim of our study was to analyse the clinical course and response to pharmacological treatment in children diagnosed with Graves' disease in first two decades after mandatory salt iodination. Records of 94 children diagnosed with GD in the years 1998-2017 were analysed. Medical data of patients was compared between two decades following implementation of iodine prophylaxis: 1998-2007 (first-decade group - FDG) and 2008-2017 (second-decade group - SDG); 34 and 60 patients, respectively. Medical data of FDG was obtained from archival records and previous analysis performed in 2006. Data of 60 patients from SDG were obtained from currently available medical records. Results were statistically analysed using Microsoft Excel and Statistica 11 software. Results: In our study, after mandatory salt iodination, the tendency of an increase in newly diagnosed GD in children without family susceptibility was observed. The antibody profile indicates the significant contribution of the autoimmune process involving all thyroid antigens; therefore, the term "autoimmune hyperthyroidism" seems to be more appropriate than classical GD in this group of patients. The first-choice treatment with methimazole rarely causes adverse events during the therapy, and they have benign character.