[Thyroid dysfunction in children with chronic renal failure]. / Alteraciones de la función tiroidea en niños con insuficiencia renal crónica.

OBJECTIVES: To determine the frequency and type of thyroid dysfunction in children with chronic renal failure (CRF) in peritoneal dialysis (PD) or hemodialysis (HD); and to establish the accuracy of the presence of goiter to identify patients with CRF and thyroid dysfunction. PATIENTS AND METHODS: This is a cross-sectional study performed in a tertiary pediatric medical care center. CRF patients younger than 17 years old, with more than three months in PD or HD were included. All patients were assessed regarding their growth and sexual development; thyroid dysfunction was evaluated by serum concentration of thyrotropin (TSH), thyroxine (T4L) and triiodothyronine (T3T). RESULTS: 50 patients were included, 25 were male, and mean age was 12 years old. There were 14 (28%) patients with thyroid dysfunction; nine had subclinical hypothyroidism, three patients had euthyroid sick syndrome and two primary hypothyroidism. Thirteen patients had goiter: seven had thyroid dysfunction and in six patients the thyroid function was normal. The sensitivity of goiter to detect thyroid dysfunction was 50% and the specificity was 83.3%. The two patients with the greatest delay in their growth were hypothyroid. CONCLUSIONS: Given that the high frequency of thyroid dysfunction in children with CRF, these patients need a systematic screening, in order to improve their quality of care.

Alteraciones de la función tiroidea en niños con insuficiencia renal crónica / No disponible

Objetivos: Determinar la frecuencia y tipo de alteraciones de la función tiroidea en niños con insuficiencia renal crónica (IRC) en programa de diálisis peritoneal (DP) o hemodiálisis (HD), así como establecer la utilidad de bocio como marcador clínico para identificar pacientes con IRC que cursan con alteraciones de la función tiroidea. Pacientes y métodos: Estudio transversal y descriptivo, realizado en un hospital pediátrico de tercer nivel de atención. Se incluyeron pacientes menores de 17 años, con IRC y con más de tres meses en DP o HD. En cada paciente se evaluó su crecimiento y desarrollo, así como la presencia de bocio. Las alteraciones tiroideas se detectaron mediante la cuantificación de los niveles séricos de tirotropina (TSH), tiroxina (T4L) y triyodotironina (T3T). Resultados: Se incluyeron 50 pacientes, 25 del sexo masculino, con edad promedio de 3 años. Hubo 14 (28%) pacientes con alteración en la función tiroidea, nueve con hipotiroidismo subclínico, tres con síndrome de enfermo eutiroideo y dos con hipotiroidismo primario. En 13 pacientes se detectó bocio, siete con disfunción tiroidea y seis con función normal. La sensibilidad del bocio para la detección de alteraciones tiroideas fue del 50%, y la especificidad del 83.3%. Dos de los pacientes con hipotiroidismo presentaron la mayor afectación en su crecimiento. Conclusiones: Debido a la alta frecuencia de alteraciones tiroideas en niños con IRC, es necesaria su valoración de manera sistemática, a fin de mejorar la calidad de su atención (AU)

Objectives: To determine the frequency and type of thyroid dysfunction in children with chronic renal failure (CRF) in peritoneal dialysis (PD) or hemodialysis (HD); and to establish the accuracy of the presence of goiter to identify patients with CRF and thyroid dysfunction. Patients and methods: This is a crosssectional study performed in a tertiary pediatric medical care center. CRF patients younger than 17 years old, with more than three months in PD or HD were included. All patients were assessed regarding their growth and sexual development; thyroid dysfunction was evaluated by serum concentration of thyrotropin (TSH), thyroxine (T4L) and triiodothyronine (T3T). Results: 50 patients were included, 25 were male, and mean age was 13 years old. There were 14 (28%) patients with thyroid dysfunction; nine had subclinical hypothyroidism, three patients had euthyroid sick syndrome and two primary hypothyroidism. Thirteen patients had goiter: seven had thyroid dysfunction and in six patients the thyroid function was normal. The sensitivity of goiter to detect thyroid dysfunction was 50% and the specificity was 83.3%. The two patients with the greatest delay in their growth were hypothyroid. Conclusions: Given the high frequency of thyroid dysfunction in children with CRF, these patients need a systematic screening, in order to improve their quality of care (AU)

[Effect of the treatment of hyperthyroidism on the course of exophthalmos]. / Influencia del tratamiento del hipertiroidismo en el curso del exoftalmos.

The exophthalmos evolution in hyperthyroid patients was investigated: twenty patients were randomly assigned to treatment with radioiodine (group I followed 2-162 months) and 20 to treatment with thyroidectomy (group II followed 2-158 months). There was no correlation of sex age and follow up with exophthalmos evolution. In group I, exophthalmos improved in one patient (5%), did not change in ten (50%) and worsened in nine (45%). In group II it got better in six (30%), did not change in seven (35%) and got worse in seven (35%). The differences between the two groups were not statistically significant (p greater than 0.05). The postsurgical thyroid gamma-gram with one mCi of I-131 in group II showed absence of thyroid tissue in nine patients (45%) and remainders of the gland in 11 (55%) and apparently this did not influence the post treatment evolution. The length of pretreatment evolution did not influence the evolution post treatment. In summary, there was no correlation between exophthalmos evolution and kind of treatment in Graves' disease.