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Fadlalbari GF, Mukhwana RO, Abdullah MA. Autoimmune hyperthyroidism in children & adolescents in Sudan: a 13 years' experience of a Paediatric Endocrinology Clinic. J Pediatr Endocrinol Metab 2020; 33:879-884. [PMID: 32658864 DOI: 10.1515/jpem-2020-0092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 04/26/2020] [Indexed: 11/15/2022]
Abstract
Background Little has been published about hyperthyroidism in children from Sudan or Africa. In limited resource countries, lack of facilities and sociocultural factors might make international diagnosis and management guidelines difficult to follow. We aimed to determine the magnitude of autoimmune hyperthyroidism, clinical presentation, diagnosis, management and its outcome in Sudan. Method Records of all patients diagnosed as Graves' disease (GD) or Hashitoxicosis (HTx) were reviewed and missing data filled by interviewing patients and/or their families. Data including age, sex, clinical presentation, investigations, management and outcome were obtained. Results Eighty-eight patients, 80 with GD (F:M = 4.7:1) and 8 with HTx (F:M = 7:1), were diagnosed at 11.8 ± 3.05 and 11.23 ± 2.78 years, respectively (p = 0.52). GD patients were diagnosed based on presence of exophthalmos (66.25%), positive thyroid receptor autoantibodies (12.5%), prolonged illness duration (8.75%) or remission failure to only B blocker (16.25%). All GD patients were started on carbimazole and cumulative remission rate was 11.8%, 32.4% and 41.2% by end of the second, third and fourth year respectively, however it plateaus after that. While 12 GD patients underwent surgery, only three opted for radioiodine ablation. Conclusion Hyperthyroidism is not an uncommon problem. In absence of laboratory facilities, differentiation between GD and HTx can be made based on clinical grounds. Continuation of medical treatment for 4 years can increase the remission rate to 41.2%. In Sudan, surgery is the preferred method of definitive therapy.
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Affiliation(s)
- Ghassan Faisal Fadlalbari
- Paediatric Endocrinology and Diabetes Unit, Gafar Ibn Auf Specialized Children Hospital, Khartoum, Sudan
| | - Renson O Mukhwana
- Department of Paediatric Endocrinology and Diabetes, Gertrude Garden Children Hospital, Nairobi, Kenya
| | - Mohamed Ahmed Abdullah
- Department of Paediatrics and Child Health, Faculty of Medicine, University of Khartoum, Sudan and Endocrinology Unit, Gafar Ibn Auf Specialized Children Hospital, Khartoum, Sudan
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Tu R, Shen H, Zhu Q, Mao G, Xu X, Yu S. A retrospective analysis of 1,231 patients with anemia after surgical treatment of hyperthyroidism. Exp Ther Med 2018; 16:4664-4668. [PMID: 30542418 PMCID: PMC6257823 DOI: 10.3892/etm.2018.6738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 08/28/2018] [Indexed: 11/05/2022] Open
Abstract
This study retrospectively analyzed the clinical and pathological data of 1,231 patients affected by anemia after surgical treatment of hyperthyroidism to explore the influencing factors of anemia after surgical treatment of hyperthyroidism. The clinical data of 1,231 patients affected by anemia after surgical treatment of hyperthyroidism from 1987 to 2017 were analyzed. Clinical data included the surgery methods, sex, age and pathological types. SPSS 22.0 statistical software was used for all statistical analyses. Correlation analyses were performed by using logistic regression analysis, and other enumeration data were subjected to χ2 test. p<0.05 was considered to be statistically significant. The occurrence of anemia after surgical treatment of hyperthyroidism was significantly correlated with age and pathological types (p<0.05). Correlation analysis also showed that age and pathological types were significantly correlated with the occurrence of anemia after surgical treatment of hyperthyroidism. Age and pathological types may be the risk factors for anemia in patients with surgical treatment of hyperthyroidism. Age and pathological type were significantly correlated with the occurrence of anemia after surgical treatment of hyperthyroidism, and may be risk factors for this disease.
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Affiliation(s)
- Ruisha Tu
- Department of Neck and Thoracic Surgery, 187th Hospital of People's Liberation Army, Haikou, Hainan 571100, P.R. China
| | - Hongfeng Shen
- Department of Urinary Surgery, 187th Hospital of People's Liberation Army, Haikou, Hainan 571100, P.R. China
| | - Qicong Zhu
- Department of Internal Medicine-Oncology, 187th Hospital of People's Liberation Army, Haikou, Hainan 571100, P.R. China
| | - Gaocai Mao
- Department of Pathology, 187th Hospital of People's Liberation Army, Haikou, Hainan 571100, P.R. China
| | - Xiaojiang Xu
- Department of Neck and Thoracic Surgery, 187th Hospital of People's Liberation Army, Haikou, Hainan 571100, P.R. China
| | - Shuyong Yu
- Department of Neck and Thoracic Surgery, 187th Hospital of People's Liberation Army, Haikou, Hainan 571100, P.R. China
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Tulchinsky M, Baum RP, Bennet K, Freeman LM, Jong I, Kairemo K, Marcus CS, Moadel RM, Suman P. Well-Founded Recommendations for Radioactive Iodine Treatment of Differentiated Thyroid Cancer Require Balanced Study of Benefits and Harms. J Clin Oncol 2018; 36:1887-1888. [DOI: 10.1200/jco.2018.78.5972] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Mark Tulchinsky
- Mark Tulchinsky, Pennsylvania State University, Hershey, PA; Richard P. Baum, Theranostics Center for Molecular Radiotherapy and Molecular Imaging, Bad Berka, Germany; K.G. Bennet, American College of Nuclear Medicine, Downers Grove, IL; Leonard M. Freeman, Albert Einstein College of Medicine, Bronx, NY; Ian Jong, Monash Health, Melbourne, Victoria, Australia; Kalevi Kairemo, Docrates Cancer Center, Helsinki, Finland; Carol S. Marcus, David Geffen School of Medicine at University of California, Los
| | - Richard P. Baum
- Mark Tulchinsky, Pennsylvania State University, Hershey, PA; Richard P. Baum, Theranostics Center for Molecular Radiotherapy and Molecular Imaging, Bad Berka, Germany; K.G. Bennet, American College of Nuclear Medicine, Downers Grove, IL; Leonard M. Freeman, Albert Einstein College of Medicine, Bronx, NY; Ian Jong, Monash Health, Melbourne, Victoria, Australia; Kalevi Kairemo, Docrates Cancer Center, Helsinki, Finland; Carol S. Marcus, David Geffen School of Medicine at University of California, Los
| | - K.G. Bennet
- Mark Tulchinsky, Pennsylvania State University, Hershey, PA; Richard P. Baum, Theranostics Center for Molecular Radiotherapy and Molecular Imaging, Bad Berka, Germany; K.G. Bennet, American College of Nuclear Medicine, Downers Grove, IL; Leonard M. Freeman, Albert Einstein College of Medicine, Bronx, NY; Ian Jong, Monash Health, Melbourne, Victoria, Australia; Kalevi Kairemo, Docrates Cancer Center, Helsinki, Finland; Carol S. Marcus, David Geffen School of Medicine at University of California, Los
| | - Leonard M. Freeman
- Mark Tulchinsky, Pennsylvania State University, Hershey, PA; Richard P. Baum, Theranostics Center for Molecular Radiotherapy and Molecular Imaging, Bad Berka, Germany; K.G. Bennet, American College of Nuclear Medicine, Downers Grove, IL; Leonard M. Freeman, Albert Einstein College of Medicine, Bronx, NY; Ian Jong, Monash Health, Melbourne, Victoria, Australia; Kalevi Kairemo, Docrates Cancer Center, Helsinki, Finland; Carol S. Marcus, David Geffen School of Medicine at University of California, Los
| | - Ian Jong
- Mark Tulchinsky, Pennsylvania State University, Hershey, PA; Richard P. Baum, Theranostics Center for Molecular Radiotherapy and Molecular Imaging, Bad Berka, Germany; K.G. Bennet, American College of Nuclear Medicine, Downers Grove, IL; Leonard M. Freeman, Albert Einstein College of Medicine, Bronx, NY; Ian Jong, Monash Health, Melbourne, Victoria, Australia; Kalevi Kairemo, Docrates Cancer Center, Helsinki, Finland; Carol S. Marcus, David Geffen School of Medicine at University of California, Los
| | - Kalevi Kairemo
- Mark Tulchinsky, Pennsylvania State University, Hershey, PA; Richard P. Baum, Theranostics Center for Molecular Radiotherapy and Molecular Imaging, Bad Berka, Germany; K.G. Bennet, American College of Nuclear Medicine, Downers Grove, IL; Leonard M. Freeman, Albert Einstein College of Medicine, Bronx, NY; Ian Jong, Monash Health, Melbourne, Victoria, Australia; Kalevi Kairemo, Docrates Cancer Center, Helsinki, Finland; Carol S. Marcus, David Geffen School of Medicine at University of California, Los
| | - Carol S. Marcus
- Mark Tulchinsky, Pennsylvania State University, Hershey, PA; Richard P. Baum, Theranostics Center for Molecular Radiotherapy and Molecular Imaging, Bad Berka, Germany; K.G. Bennet, American College of Nuclear Medicine, Downers Grove, IL; Leonard M. Freeman, Albert Einstein College of Medicine, Bronx, NY; Ian Jong, Monash Health, Melbourne, Victoria, Australia; Kalevi Kairemo, Docrates Cancer Center, Helsinki, Finland; Carol S. Marcus, David Geffen School of Medicine at University of California, Los
| | - Renee M. Moadel
- Mark Tulchinsky, Pennsylvania State University, Hershey, PA; Richard P. Baum, Theranostics Center for Molecular Radiotherapy and Molecular Imaging, Bad Berka, Germany; K.G. Bennet, American College of Nuclear Medicine, Downers Grove, IL; Leonard M. Freeman, Albert Einstein College of Medicine, Bronx, NY; Ian Jong, Monash Health, Melbourne, Victoria, Australia; Kalevi Kairemo, Docrates Cancer Center, Helsinki, Finland; Carol S. Marcus, David Geffen School of Medicine at University of California, Los
| | - Paritosh Suman
- Mark Tulchinsky, Pennsylvania State University, Hershey, PA; Richard P. Baum, Theranostics Center for Molecular Radiotherapy and Molecular Imaging, Bad Berka, Germany; K.G. Bennet, American College of Nuclear Medicine, Downers Grove, IL; Leonard M. Freeman, Albert Einstein College of Medicine, Bronx, NY; Ian Jong, Monash Health, Melbourne, Victoria, Australia; Kalevi Kairemo, Docrates Cancer Center, Helsinki, Finland; Carol S. Marcus, David Geffen School of Medicine at University of California, Los
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