ETIOLOGICAL PROFILE OF GOITER AND CORRELATION BETWEEN IODINE NUTRITIONAL STATUS WITH AUTOIMMUNE THYROIDITIS IN CHILDREN

Abstract : Despite years of salt iodization, goiter continues to be a major public health problem worldwide. Iodine intake has a marked influence on the incidence and prevalence of thyroid abnormalities in a population and excess iodine exposure was reported to be associated with autoimmune thyroiditis (AIT) and thyroid dysfunction. Measurement of urinary iodine excretion (UIE) reflects a persons iodine nutritional status and WHO recommend it to be used as the primary impact indicator for monitoring salt iodisation programme.AIM a. To evaluate for possible etiologies of goiter in children using a standard approach and b. To assess iodine nutrition and to correlate iodine nutritional status with autoimmune thyroiditis in children.MATERIALS AND METHODSDESIGN Descriptive studySTUDY PERIOD January 2010 to May 2011,STUDY POPULATION All children with goiter during the study period between age group 6-12 yrs, attending the pediatric endocrinology outpatient department of our institute. Children with proven congenital hypothyroidism were excluded from the study.MANOUVERE 59 Children with goiter were enrolled in the study. All 59 children were subjected to blood tests for T4, TSH, thyroid microsomal, antithyroglobulin antibody titres and Fine needle aspiration (FNAC). Urinary iodine excretion (UIE) was estimated in spot urine samples. RESULTS Among the various etiologies of goiter, autoimmune thyroiditis 42(71.2) was the commonest, followed by euthyroid goiter 13(22) and iodine deficiency 4(6.8) being the least. mild IDD was present only in 4 (6.8) children, 11 (18.6) had adequate iodine nutrition 17 (28.8) had UIE above normal requirements and 27(45.8) children had UIE more than 300ugL. The levels of urinary iodine were significantly higher in children with autoimmune thyroiditis compared with euthyroid goiter (316.9586.124 vs.167.94 58.72, p0.001).CONCLUSION In any child presenting with goiter complete work up is necessary, so as to decide upon a rational treatment. A possible link between increased iodine intake and autoimmune thyroiditis was found in our study.