Τίτλος:
Predominant form of non-toxic goiter in Greece is now autoimmune
thyroiditis
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Endemic non-toxic goiter (NTG) in Greece has been attributed primarily
to iodine deficiency. Thirty years ago about 60% of the prepubertal
boys and girls examined in endemic goiter regions presented with NTG and
among them thyroid autoimmunity was rarely detected. Although iodine
supplementation has corrected this deficiency during the past 30 years,
new cases of NTG still appear. To evaluate the prevalence and type of
NTG and the effect of iodine supplementation on them in Greece at
present, we performed two cross-sectional clinical studies and a
retrospective pathology one: (i) thyroid gland volume and urinary iodine
excretion (UIE) were assessed in a representative sample of 1213
schoolchildren from previously endemic and non-endemic regions; (ii)
serum thyroxine, tri-iodothyronine, TSH, thyroid autoantibodies (AAB)
(anti-thyroid peroxidase and anti-thyroglobulin antibodies) and UIE (in
60 patients) were measured in 300 consecutive patients with NTG from
Athens and Heraklion; and (iii) we compared the prevalence of
autoimmunity among fine needle aspiration smears of benign thyroid
pathologies performed by the same pathologist between 1985 and 1986 (975
cases) and between 1994 and 1995 (2702 cases). We found that 12.5% of
the schoolchildren examined in regions with a previous history of
endemic goiter had NTG, whereas this percentage was only 1.7% in areas
without such a history. In Athens (61.6%) and Heraklion (58.5%) a
substantial number of NTG patients were AAB positive and biochemically
hypothyroid. UIE in Athens did not differ between patients with
autoimmune goiter (ATG) and simple goiter. The prevalence of autoimmune
stigmata in pathology smears has increased from 5.94% (years 1985-1986)
to 13.91% (years 1994-1995) (P<0.05). We conclude that: (ii the
persistence of endemic goiter in regional foci despite iodine deficiency
correction suggests a possible Pole for a naturally occurring goitrogen:
(iii) ATG is the predominant form of NTG in Greece nowadays: and (iii)
the Eve-fold decrease in the prevalence of NTG during the past 30 years
followed by the increase of ATG map support the relative character of
the latter.
Συγγραφείς:
Doufas, AG
Mastorakos, G
Chatziioannou, S
Tseleni-Balafouta,
S
Piperingos, G
Boukis, MA
Mantzos, E
Caraiskos, CS and
Mantzos, J
Alevizaki, M
Koutras, DA
Περιοδικό:
European Journal of Endocrinology
Εκδότης:
BioScientifica Ltd
DOI:
10.1530/eje.0.1400505
