Tip 1 diabetes mellituslu çocuklarda ilk tanıdaki tiroid fonksiyon anormallikleri: Kalıcı mı? Geçici mi?
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Date
2008
Authors
Semiz, Serap
Candemir, Maşallah
Karakuş, Tuğrul
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Amaç: Bu çalışmada; yeni tanılı Tip 1 diabetes mellituslu olgularda, ilk başvuru anındaki anormal tiroid fonksiyon testleri görülme sıklığını ve bunların kısa süreli takip sonuçlarını değerlendirmeyi amaçladık. Gereç ve Yöntem: 2001-2006 yılları arasında, ilk tanıyı hastanemiz Çocuk Sağlığı ve Hastalıkları Kliniği’nde alan ve bu tanıyla takip edilen Tip 1 diabetes mellituslu 42 hastanın tiroid fonksiyon testleri retrospektif olarak incelendi. Hastaların, başvuru anından itibaren, ortalama 4.5’uncu günde, tiroid fonksiyon testleri ve tiroid otoantikorlarına bakıldı. Tiroid fonksiyon testleri median 180. günde tekrar değerlendirildi. Bulgular: Hastaların 22’si (%52.4) kız, 20’si (%47.6) erkek idi ve ortalama yaş 9.4 (±3.6) olarak saptandı. Başvuru anında 23 (%54.8) hasta diabetik ketoasidoz, 15 (%35.7) hasta ketozis ve 4 (%9.5) hasta ise hiperglisemi tablosunda idi. Hastaların 26’sı (% 61.9) ötiroid iken, 16’sında (% 38.1) tiroid fonksiyon testlerinde bozukluk saptandı. Anormal tiroid fonksiyonu tespit edilen hastalardan 12’sinin (%75.0) ötiroid hasta sendromu olduğu görüldü ve bu hastalardan 10’unun (%83.3) başvuru kliniği diabetik ketoasidoz idi. Bu olguların çoğunun geçici olduğu, bir tanesi dışında tümünde anormal tiroid fonksiyon testlerinin düzeldiği görüldü. Başvuruda ketozis veya hiperglisemi kliniği olan olguların 2’sinde (%10.5), diabetik ketoasidozlu olguların 5’inde (%21.7) olmak üzere toplam 7 (%16.7) olguda tiroid antikor pozitişiği mevcuttu. Kontrolde toplam 42 hastadan, 6’sinda (%14.3) anormal TFT saptandı ve başlangıçtaki tiroid disfonksiyonu %38.1’den, %14.3’e geriledi. Sonuç: Bu retrospektif çalışma ile yeni tanılı Tip 1 diabetes mellituslu olgularda tiroid fonksiyon testlerindeki anormalliklerin sık, çoğunlukla geçici olduğu saptanmıştır. Bu nedenle tiroid patolojisi düşündüren herhangi bir klinik durum yok ise, tiroid fonksiyon testlerinin ilk tanıdan en az 1 ay sonra değerlendirilmesinin uygun olacağı kanısındayız.
Aim: In this study, we aimed to determine the incidence and short term outcome of abnormal thyroid functions in children with newly diagnosed type 1 diabetes mellitus. Materials and Methods: Fourty-two patients with Type 1 diabetes mellitus who were diagnosed and observed in our department of pediatrics between 2001-2006 were retrospectively evaluated. The thyroid function tests of the patients were measured within four and a half days of the initial diagnosis of diabetes and at least one follow-up test median on day 180 after diagnosis. Results: Twenty-two (52.4%) of the patients were female and 20 (47.6%) were male. Mean age of the patients was 9.4 (±3.6) years. Twenty-three patients (54.8%) were diagnosed as diabetic ketoacidosis, 15 (35.7%) as ketosis and 4 (9.5%) as hyperglycemia at the time of initial presentation. Thyroid functions were normal in 26 (61.9%) subjects. Thyroid function tests were abnormal in 16 (38.1%) subjects of whom 12 (75.0%) had biochemical findings compatible with sick euthyroid syndrome and of these 10 (83.3%) had diabetic ketoacidosis. All of these abnormalities were transient and thyroid function tests all returned to normal except for one patient. Antithyroid antibodies were positive in 7 (16.7%) subjects 2 (10.5%) with ketosis or hyperglycemia and 5 (21.7%) diabetic ketoacidosis. Thyroid function tests were abnormal in 6 (14.3.1%) subjects at follow-up. Thyroid disfunction rate decrased the 38.1% to 14.3% at the follow-up. Conclusion: This retrospective study revealed that abnormalities in thyroid function tests in subjects with newly diagnosed Type 1 diabetes mellitus were frequent and mostly transient. For this reason, in the absence of any clinical situation suggesting a thyroid disorder, we think it would be better to assess thyroid function tests at least one mouth after theinitial diagnosis of diabetes.
Aim: In this study, we aimed to determine the incidence and short term outcome of abnormal thyroid functions in children with newly diagnosed type 1 diabetes mellitus. Materials and Methods: Fourty-two patients with Type 1 diabetes mellitus who were diagnosed and observed in our department of pediatrics between 2001-2006 were retrospectively evaluated. The thyroid function tests of the patients were measured within four and a half days of the initial diagnosis of diabetes and at least one follow-up test median on day 180 after diagnosis. Results: Twenty-two (52.4%) of the patients were female and 20 (47.6%) were male. Mean age of the patients was 9.4 (±3.6) years. Twenty-three patients (54.8%) were diagnosed as diabetic ketoacidosis, 15 (35.7%) as ketosis and 4 (9.5%) as hyperglycemia at the time of initial presentation. Thyroid functions were normal in 26 (61.9%) subjects. Thyroid function tests were abnormal in 16 (38.1%) subjects of whom 12 (75.0%) had biochemical findings compatible with sick euthyroid syndrome and of these 10 (83.3%) had diabetic ketoacidosis. All of these abnormalities were transient and thyroid function tests all returned to normal except for one patient. Antithyroid antibodies were positive in 7 (16.7%) subjects 2 (10.5%) with ketosis or hyperglycemia and 5 (21.7%) diabetic ketoacidosis. Thyroid function tests were abnormal in 6 (14.3.1%) subjects at follow-up. Thyroid disfunction rate decrased the 38.1% to 14.3% at the follow-up. Conclusion: This retrospective study revealed that abnormalities in thyroid function tests in subjects with newly diagnosed Type 1 diabetes mellitus were frequent and mostly transient. For this reason, in the absence of any clinical situation suggesting a thyroid disorder, we think it would be better to assess thyroid function tests at least one mouth after theinitial diagnosis of diabetes.
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Keywords
Tip 1 diabetes mellitus, Tiroid fonksiyon testleri, Type 1 diabetes mellitus, Thyroid function tests
Citation
Semiz, S. vd. (2008). "Tip 1 diabetes mellituslu çocuklarda ilk tanıdaki tiroid fonksiyon anormallikleri: Kalıcı mı? Geçici mi?". Güncel Pediatri, 6(1), 5-9.