Hyperthyroidism of the Child in Abidjan (Côte d’Ivoire). Retrospective Study of 27 Cases
Richard AZAGOH-KOUADIO*, Kouadio Vincent ASSE, Jacob Slanziahuelie ENOH, Line Guei COUITCHERE, Kouassi Christian YAO, Lassina CISSE, Jean-jacques YAO Atteby, Soumahoro OULAI
Introduction: Hyperthyroidism is a rare endocrinopathy of various causes, severe and poorly documented in children from Saharan Africa.
Objective: Describe the epidemiological, diagnostic, therapeutic and prognostic aspects of child hyperthyroidism to improved prognosis. Materials and methods: This was a retrospective, descriptive and analytical study carried out in the pediatric department of the University and Teaching Hospital of Treichville from January 2012 to December 2016. It included all children aged 0 to 15 years hospitalized for
hyperthyroidism diagnosed on clinical grounds and biological. The variables studied were the epidemiological, diagnostic, therapeutic and issue aspects.
Results: We recorded 24,000 admissions, where 27 cases was of hyperthyroidism, so let say 1 case per thousand admissions. Hyperthyroidism involved 22 girls and 5 boys. Age was between 11 and 15 years in 89% of cases. The main signs were tachycardia (100%), goitre (100%), exophthalmia (89%), weight loss (81.5%), dyspnea (63%) and tremor (44%). T3, T4 levels were above normal in 99% of cases. TSH was low in 96% of the cases. The causes were Graves-Basedow disease (81.4%), toxic adenoma (11.1%), multinodular goitre (3.7%) and thyroiditis (3.7%). Synthesis of antithyroid drugs was marked by remission (52%), discharge against medical advice (33%) and death (15%). The age of more than 10 years (P = 0.031) and the synthetic antithyroid attack dose ≥ 1 mg / kg / day (P = 0.023) were significantly associated with remission.
Conclusion: The hyperthyroidism rare pathology of the child, affects especially the teenager with a female predominance. Graves-Basedow disease remains the most common etiology. The treatment is based on synthetic antithyroid drugs (ATS). Thyroidectomy is a therapeutic alternative. To improve the forecast, we needs a close cooperation between the pediatrists, the endocrinologists and the surgeon-pediatrists