Endocrine Abstracts

The combination of GD and FTS in children is extremely rare and is poorly understood. RSSPMC of Endocrinology named after Academician Y. Kh. Turakulov, a girl A.M., 12 years 11 months old, living in the Namangan region, was hospitalized for the purpose of diagnosis and correction of treatment. Complaints corresponded to the clinic of HT, also included bilateral protrusion of the eyeballs, lacrimation, reddening of the conjunctiva, feeling of a foreign body in the eyes, blurred vision. Anthropometry revealed severe underweight, BMI 13.9 (BMI z-score = -2.75), secondary short stature (height z-score = -1.31). Pulse 118 beats per minute, blood pressure 130/70 mm Hg. Sexual development according to Tanner 1. The thyroid gland is diffuse on palpation, enlarged to grade 2 (WHO), visible to the eye, stringy, of moderate density, mobile, painless. Peripheral lymph nodes are not palpable. Electrochemiluminescent immunoassays ECLIA from Roche Diagnostics GmbH (Germany) determined overt autoimmune HT. Ultrasound of the thyroid gland - diffuse enlargement of the thyroid gland, volume = 48mm3. Graves’ disease, Graves’ ophthalmopathy was diagnosed. Thyrostatic therapy was prescribed with the Tab. Thiamazole orally at a dose of 20 mg / day according to a descending scheme under the control of biochemical analyzes and instrumental examination by an endocrinologist at the place of residence. After 2 years, the girl was again admitted to our center with a relapse of GD. Palpation of the thyroid gland revealed nodes in both lobes with a diameter of up to 0.8-1.2 cm, the thyroid gland is mobile, painless, regional lymph nodes are not enlarged. TAB thyroid - Bethesda V. Preoperative preparation was carried out, after reaching euthyroidism, Lugol’s solution was prescribed 8 drops 2 times a day and total thyroidectomy (TTE) was performed. Histological examination - follicular thyroid cancer. Conducted radioiodine therapy (RIT) 1200 MBC. Suppressive therapy prescribed. Levothyroxine sodium in a dose. Thyroid status is currently presented in Table 1. There are no complaints. Persistent remission.

Conclusion: GD is a rare pathology in children, FTC is diagnosed even less often. In this case, GD is more often combined with papillary TC. However, this case is an example of the coexistence of autoimmune diseases, Graves’ disease, and follicular thyroid cancer in a child who required total thyroidectomy and radioiodine therapy. No matter how extremely rare the combination of GD and FTC in children is, we must remember that this is possible.