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Endemic goiter in children
Last reviewed: 23.04.2024
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The most common manifestation of iodine deficiency is endemic goiter. The formation of goiter is a compensatory reaction aimed at maintaining the homeostasis of thyroid hormones in the body.
According to research, the prevalence of endemic goiter in children and adolescents is 15-25%. The actual average consumption of iodine by a resident of Ukraine is only 40-60 μg per day with a daily requirement of 100-200 μg.
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Treatment of endemic goiter in children
In the presence of diffuse enlargement of the thyroid gland according to palpation or ultrasound after exclusion of autoimmune thyroiditis, iodine preparations are prescribed in a daily dose of 200 mcg for at least 6 months. Later on they switch to maintenance doses of iodine preparations. If the background of taking iodine medications for 6 months did not normalize the size of the thyroid gland, the use of levothyroxine sodium is indicated. After normalizing the size of the thyroid gland, according to ultrasound, it is recommended to switch to a long-term intake of drugs containing preventive doses of iodine.
Drugs
Prevention of endemic goiter
There are three ways to prevent endemic goiter.
- Mass iodine prophylaxis is prophylaxis at the population scale, carried out by introducing iodine into food products (using iodized salt).
- Group iodine prophylaxis - on the scale of high risk groups for the development of iodine deficiency disorders (children, adolescents, pregnant and lactating women). It is carried out by regular long-term intake of drugs containing physiological doses of iodine (potassium iodide): children under 12 years old - 50-100 mcg / day, adolescents - 100-200 mcg per day, pregnant and lactating mothers - 200 mcg per day.
- Individual iodine prophylaxis is prophylaxis in individuals by prolonged intake of drugs containing physiological doses of iodine.
Forecast
The course of diffuse non-toxic goiter is very variable. It is possible to maintain hyperplasia of the thyroid gland without disrupting function for many years. In some cases, the development of hypothyroidism, the emergence of nodal formations. Any increase in the size of the thyroid gland determines the need for regular dispensary observation. When carrying out group and mass prophylaxis of iodine deficiency diseases, the frequency of goiter is significantly reduced.