Endocrine Abstracts

Aim: To study the thyroid and cognitive status and psycho-emotional health of children and adolescents with Graves’ disease (GD).

Materials and methods: 37 children and adolescents with GD examined in the Republican Medical Center of Endocrinology (Uzbekistan). The control group consisted of 19 healthy children and adolescents. Thyroid status was determined using a closed-type immunochemistry analyzer Cobas e411 Hitachi from HoffmanLeRoche (Switzerland) and its reagents. To assess the level of intelligence of children, standard progressive Raven matrices were used. Spielberg Questionnaire (State-Trait Personal Inventory) was used to determine anxiety syndrome. The differences were considered statistically significant at P < 0.05.

Results: In Uzbekistan, according to the annual statistical report for 2018, the dispensary includes 145 children and adolescents with GD. We examined 37 children with GD, which amounted to 25.5% of all children with GD in Uzbekistan. At the time of the first treatment, all children with GD had a pronounced thyrotoxicosis clinic with a reliably low TSH level (0.014 ± 0.024, P < 0.01), high fT4 values (5.1 ± 0.2, P < 0.05) and TRAbs interval was 2.5–40.0 IU/l with a median (Me) of 11.6 (17.0 ± 1.1, P < 0.0001). In the same group, 83.8% (31) showed high values of TPO Ab. In the control group, 8.3% (1) also showed elevated levels of TPO Ab. In a group of GD, 100% of children showed a high level of anxiety, 70.3% (26) showed a high degree of negative emotional experiences and low cognitive activity. Children with GD were dominated by indicators of insecurity, anxiety, self-distrust, a sense of inferiority and hostility, a tendency to conflict, difficulties in communication, and depression were noted. The total IQ adjusted for age in children and adolescents with GD was 73.9 ± 14.8 (min 55, max 96, Me 75). In the control group, this indicator was 120.2 ± 7.5 points (min 106, max 133, Me 115; P < 0.001). In the group with GD, no children with extraordinary intelligence were detected. In 43.2% (16) adolescents, the IQ level corresponded to an average degree of intelligence, in 56.8% (21) it was below average. At the same time, 51.4% (19) of children in this group showed endocrine encephalopathy.

Conclusions: In all adolescents with thyrotoxicosis, anxiety, and negative emotional experiences prevailed, while the cognitive activity in these children was lower in comparison with the control group. Children with GD have defects in intellectual ability and impaired attention and/or perception.