A study of goiter among female adolescents referred to Centre for Nuclear Medicine, Lahore
Elahi, S.; Manzoor ul Hassan, A.; Syed, Z.; Nazeer, L.; Nagra, S.A.; Hyder, S.W.
Pakistan Journal of Medical Sciences 21(1): 56-62
2005
ISSN/ISBN: 1682-024X Document Number: 254419
Objective: To study goitre and thyroid dysfunction in female adolescents residing in Lahore referred to the 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 FT4 and TSH levels. Setting: Centre for Nuclear Medicine (CENUM), Mayo Hospital, Lahore, Pakistan. Patients: 350 female adolescent referred during September 2002-April 2003. Main outcome measures: adolescent goitre, thyroid nodules, hyperthyroidism, hypothyroidism, Graves' disease, toxic multinodular goitre. Results: Among 350 adolescents, 212 (60.6%) had goitre 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 goitre (20.7%) was more than multinodular goitre (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 goitre (p<0.005). More than 80% of the patients with solitary nodular goitre were euthyroid. Simple goitre 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 goitre but duration of goitre was not significant in promoting nodularity. Conclusion: Goiterous adolescents need urgent attention because they do not have just diffuse hypertrophy with normal thyroid function. Many are afflicted with dysfunction and nodularity, particularly solitary cold nodule bearing risk of thyroid malignancy.