Thyroid peroxidase antibody positivity and triiodothyronine levels are associated with pediatric Graves'ophthalmopathy

Background:Graves'ophthalmopathy(GO)occurs commonly in children with Graves'disease(GD).However,there are limited studies on the clinical manifestations and thyroid autoantibodies in pediatric GO.The aim of this study was to investigate the prevalence and risk factors of GO in childhood GD.Methods:Clinical and biochemical data from children and adolescents with GD were retrospectively reviewed.Eighty patients under 19 years of age were included in the present study.We compared the clinical and biochemical differences between patients with and without GO.Results:Thirty-nine percent of the patients had GO,and 81%of the GO patients were females.Of these,two patients showed unilateral GO.Triiodothyronine(T3)levels were higher in GO patients than in those without GO.Anti-thyroglobulin antibody and thyroid stimulating hormone receptor antibody titers were not significantly different between the two groups.Anti-thyroid peroxidase antibody(TPO Ab)positivity was 68%in the patients with GO and only 47%in the patients without GO.In multivariate regression analysis,high T3 levels and TPO Ab positivity were related to the presence of GO.Conclusion:In children and adolescents with GD,TPO Ab positivity and high T3 levels could act as predictive factors for the presence of GO.

Clinical effect of methimazole combined with selenium in the treatment of toxic diffuse goiter in children

BACKGROUND The incidence of toxic diffuse goiter(Graves’disease)is higher in adolescents and preschool-aged children,with an upward trend.The incidence at 6–13 years of age is approximately 11.0%,and the incidences in men and women are 7.8%and 14.3%,respectively.AIM To explore the clinical effect of methimazole combined with selenium in the treatment of toxic diffuse goiter(Graves’disease)in children and its effect on serum anti-thyroglobulin antibody(TRAb)and anti-thyroid peroxidase antibody(TPOAb).METHODS A total of 103 children with Graves’disease treated in our hospital from January 2018 to June 2021 were divided into a traditional group and a combined group(15-20 mg methimazole orally given to children)and a combined group(50μg selenium added on the basis of traditional treatment)according to different treatment methods to explore the therapeutic effects of the two methods and to observe the changes in thyroid volume and serum TRAb,TPOAb,free thyroxine(FT4)and inflammatory factor levels before and after treatment.The time taken for FT4 to return to normal was compared between the two groups.RESULTS Treatment was significantly more effective in the combined group than in the traditional group(P<0.05).The thyroid volumes of the children in the two groups was measured before and after treatment.Thyroid volume decreased significantly after treatment in both groups,and the thyroid volume was significantly lower in the combined group than in the traditional group(P<0.05).The serum levels of interleukin-6(IL-6),IL-8,TRAb,TPOAb and FT4 in the two groups were detected before and after treatment.The levels of IL-6,IL-8,TRAb,TPOAb and FT4 were significantly lower in the combined group than in the traditional group(P<0.05).Follow-up of the children in the two groups showed that compared with the traditional group,it took less time for children in the combined group to return to the normal level(P<0.05).CONCLUSION Methimazole combined with selenium can effectively treat Graves’disease in children,reduce the expression of TRAb,TPOAb,FT4 and inflammatory factors,and improve the curative effect.Thus,the combined treatment warrants further clinical research.

Association between serum levels of TSH and free T4 and per- and polyfluoroalkyl compounds concentrations in pregnant women

Many per-and polyfluoralkyl substances(PFASs)may disrupt maternal thyroid hormone homeostasis in pregnancy.Concerns should be raised regarding the PFASs exposure in pregnant women because thyroid hormones are involved in the early development of the fetus.In this study,we measured the concentrations of 13 PFASs,including five novel shortchain PFASs,in serum from 123 pregnant women in Beijing,China.Linear regression models were used to investigate the association between thyroid-stimulating hormone(TSH)or free thyroxine(FT4)levels and PFASs concentrations under consideration of the impacts of pregnancy-induced physiological factors.We found that perfluorobutanoic acid(PFBA)(β=0.189,95%CI=-0.039,0.417,p=0.10)and perfluorodecanoic acid(PFDA)(β=-0.554,95%CI=-1.16,0.049,p=0.071)were suggestive of significant association with TSH in thyroid peroxidase antibody(TPOAb)negative women.No association was observed between all PFASs and FT4 levels after controlling for these confounding factors,such as BMI,gestational weight gain and maternal age.These findings suggest that it should pay more attention to the association between thyroid hormone levels and short-chain PFASs concentrations.Future studies could consider a greater sample and the inclusion of other clinical indicators of thyroid function,such as free T3 and total T3.