ECE2016 Eposter Presentations Thyroid (non-cancer) (120 abstracts)
Long-term universal salt iodization has resulted now in more than adequate iodine intake and consequent chronic autoimmune thyroiditis in school-age children living in some localities from Mures and Harghita Counties, Romania
Zsuzsanna Szántó 1, , Zsuzsánna Réti 1, , Anna Gáll 4 , Iolanda Ballók 5 , Attila Csiszér 6 , Előd Nagy 7 , Zsuzsanna Croitorescu 8 , Anna Dávid 9, , Margit Hadnagy 11 , Emőke Barbara László 11 , Hella Zier 11 , Zsuzsa Tankó 2 , Zsuzsanna Gál 11 & Imre Zoltán Kun 2,
1Department of Endocrinology, University of Medicine and Pharmacy, Tîrgu Mures, Romania; 2Clinical Department of Endocrinology, Clinical Hospital Mures County, Tîrgu Mures, Romania; 3Topmed” Medical Center, Tîrgu Mures, Romania; 4School Dispensary, Miercurea Ciuc, Harghita County, Romania; 5General Practitioner, Unit Glajarie, Mures County, Romania; 6Regional Center of Public Health, National Institute of Public Health, Tîrgu Mures, Romania; 7Department of Biochemistry, Faculty of Pharmacy, University of Medicine and Pharmacy, Tirgu Mures, Romania; 8Central Laboratory of Clinical Hospital Mures County, Tîrgu Mures, Romania; 9Clinical Department of Dermatology, Clinical Hospital Mures County, Tîrgu Mures, Romania; 10Doctoral School of University of Medicine and Pharmacy, Tîrgu Mures, Romania; 11University of Medicine and Pharmacy, Tîrgu Mures, Romania.
Introduction: In Romania universal salt iodization was implemented into practice since 2002, and iodine content of salt was gradually increased afterward. The efficiency and sustainability of this nationwide program were evaluated among school children from endemic regions of Mures and Harghita Counties. During these studies thyroid ultrasound characteristic for chronic autoimmune thyroiditis was observed in a considerable number of cases.
Objective: To estimate the iodine status in schoolchildren living in some localities of the two counties, and to detect cases with chronic autoimmune thyroiditis.
Material and methods: In 374 schoolchildren with age between 6 to 14 years physical exam, anthropometric evaluation, thyroid ultrasound, morning urinary iodine concentration (UIC), and in case of suggestive ultrasound appearance for thyroid autoimmunity the level of serum thyroid stimulating hormone (TSH), free-thyroxine (fT4) and anti-thyroid peroxidase antibodies (TPO-Ab) were assessed.
Results: Mean and median UIC were 342±197 μg/l and 298 μg/l, respectively, in Mures County during 2013–2014, as well as 248±127 μg/l and 215 μg/l in Harghita County during 2014–2015. Moreover 41.4% of children from Mures County and 38.4% from Harghita County had high UIC. The frequency of goiter was 4.7% in the whole cohort. We observed hypoechoic and/or inhomogeneous thyroid on ultrasound in 17.7%, from which in 9 children chronic autoimmune thyroiditis, and subsequent subclinical or overt hypothyroidism was demonstrated.
Conclusion: The universal salt iodization program has eliminated iodine deficiency in the investigated endemic regions from Mures and Harghita Counties, but it seems that the iodine intake is more than adequate, even excessive by now. Harmful consequences, such as chronic autoimmune thyroiditis might appear, as was seen in our cohort. Consequent follow-up is needed to clarify the clinical course and importance of cases with hypoechoic, inhomogeneous ultrasound picture of thyroid, without TPO-Ab-positivity in schoolchildren with normal/high iodine intake, living in former iodine-deficient regions.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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