Hereditary hemochromatosis (HH) is a rare genetic disorder, developing secondary to the accumulation of iron in tissues, which may lead to multiple organ failure. If untreated, it may result in liver cirrhosis or cardiomyopathy. The damage to the pancreas and the anterior pituitary, on the other hand, leads to a decreased production and secretion of hormones that are essential to life. Common symptoms of HH, that are distressing for patients, include joint pain, particularly involving hands and wrists, as well as the chronic fatigue syndrome. Iron overload affects the skeletal system, leading to osteoporosis. The pathological accumulation of iron in the anterior pituitary impairs the gonadotropin synthesis, resulting in reduced serum levels of testosterone in men and estrogens in women. This, however, contributes to lower bone mass. In vivo tests have also revealed that abnormal iron accumulation is related to an increased activity and number of osteoclasts, as well as the influence on the differentiation and activity of osteoblast-lineage cells. Based on a systematic review of literature, hereditary hemochromatosis (HH) will be presented as a chronic disease, affecting most of the endocrine glands.
Hereditary hemochromatosis (HH) is a rare genetic disorder, developing secondary to the accumulation of iron in tissues, which may lead to multiple organ failure. If untreated, it may result in liver cirrhosis or cardiomyopathy. The damage to the pancreas and the anterior pituitary, on the other hand, leads to a decreased production and secretion of hormones that are essential to life. Common symptoms of HH, that are distressing for patients, include joint pain, particularly involving hands and wrists, as well as the chronic fatigue syndrome. Iron overload affects the skeletal system, leading to osteoporosis. The pathological accumulation of iron in the anterior pituitary impairs the gonadotropin synthesis, resulting in reduced serum levels of testosterone in men and estrogens in women. This, however, contributes to lower bone mass. In vivo tests have also revealed that abnormal iron accumulation is related to an increased activity and number of osteoclasts, as well as the influence on the differentiation and activity of osteoblast-lineage cells. Based on a systematic review of literature, hereditary hemochromatosis (HH) will be presented as a chronic disease, affecting most of the endocrine glands.
We present an additional sonographic sign of Hashimoto’s thyroiditis (HLT), increasing the specificity of this method in pediatric populations. Methods: A total of 98 children (mean age 12.7 years, range 7–17 years) were selected from the registry of the endocrinology outpatient department. All subjects met the diagnostic criteria for HLT. All children underwent a prospective thyroid ultrasound examination with special attention paid to the presence of lymph nodes adjacent to the thyroid gland. In order to form a control group, we analyzed 102 healthy volunteers and 94 children with cervical lymphadenopathy, age- and sex-matched with the main study group. Results: The ultrasound of the thyroid revealed typical sonographic signs of autoimmune thyroid disease in all children with HLT and in none of the individuals in the control groups. In 96 children (98%) from the HLT group, at least 2 lymph nodes adjacent to the lower part of the thyroid gland lobes localized on one or both sides of the thyroid were detected. No lymph nodes adjacent to the lower part of the thyroid lobes were found in healthy children or children with cervical lymphadenopathy. Conclusions: Lymph nodes adjacent to the lower part of the thyroid lobes are an additional ultrasound sign of pediatric Hashimoto’s lymphocytic thyroiditis, with 98% sensitivity and 100% specificity.
PL
W niniejszej pracy została przedstawiona dodatkowa cecha ultrasonograficzna przewlekłego limfocytowego zapalenia tarczycy, zwiększająca specyficzność tej metody w populacji dzieci. Materiał i metody: Z rejestru kliniki endokrynologii wybrano 98 dzieci (średnia wieku: 12,7 roku, przedział wiekowy: 7–17 lat). Wszyscy pacjenci spełniali kryteria diagnostyczne choroby Hashimoto. Każde dziecko poddano prospektywnemu badaniu ultrasonograficznemu tarczycy ze szczególnym uwzględnieniem występowania węzłów chłonnych przylegających do tarczycy. W celu utworzenia grupy kontrolnej analizie poddano 102 zdrowych ochotników oraz 94 dzieci z limfadenopatią szyjną, dopasowanych pod względem wieku i płci do badanej grupy. Wyniki: Badanie ultrasonograficzne tarczycy ujawniło typowe cechy sonograficzne autoimmunologicznej choroby tarczycy u wszystkich dzieci z chorobą Hashimoto i nie ujawniło ich u żadnego pacjenta z grupy kontrolnej. U 96 chorych dzieci (98%) wykryto co najmniej dwa węzły chłonne przylegające do dolnej części płatów tarczycy, umiejscowione z jednej lub z dwóch stron gruczołu. Nie wykryto węzłów chłonnych przylegających do dolnej części płatów tarczycy u dzieci zdrowych ani u dzieci z limfadenopatią szyjną. Wnioski: Występowanie węzłów chłonnych przylegających do dolnej części płatów tarczycy stanowi dodatkową cechę ultrasonograficzną zapalenia tarczycy Hashimoto u dzieci, wykazującą 98-procentową czułość i 100-procentową specyficzność.
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.