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    Children with hyperthyroidism pediatric endocrine disease is one of the most common diseases of Tianjin Children's Hospital, according to statistics, the incidence is ranked second, behind obesity and subclinical hypothyroidism hyperthyroidism; approximately 5% of total cases. The disease can occur 吃中药治甲亢上那个医院好
inducement. The disease is due to thyroid hormone secretion caused by too much, often associated with thyroid enlargement, proptosis and increased basal metabolic rate and other performance. L, etiology and classification: ( 1) diffuse toxic goiter, also known as Graves or Basedow disease is a disease, autoimmune disease. The patient only a defect in the immune system, mainly in the aspects of humoral immunity, with many exciting thyroid immune globulin ( TSl ), such as the last known as lats ( LATS ), LATS - Protection (LATS - P), the determination of the thyrotropin receptor antibody ( TRAB ), although there are TSH binding inhibition of immunoglobulin ( TB Ⅱ), 成都华西医院甲亢治疗
in the onset and course of excitatory antibodies predominate. In cellular immunity performance for the inhibition of T cell clonal abnormalities, its function was significantly reduced by immune dysregulation, released on T helper cells, sensitized effector cells inhibition, so that the latter attack thyroid tissue cells, helper T cell help B cells into plasma cells, produce a large number of thyroid stimulating antibody pathogenic. Untreated Graves disease LATS positive rate was 50%, LATS-P was 90%, and TRAB can be as high as 83% - 100%. With the treatment of TRAB positive rate decreased gradually. If the TRAB to maintain long-term negative, hyperthyroidism will not relapse. The genetic and environmental factors such as mental stimulation, mood swings, ideological burden is overweight wait and youth development and infection are related with the disease induced by. ( 2) nodular toxic goiter: also known as Plumivier disease. A section of thyroid nodular hyperplasia, some may develop adenoma. Intertubercular tissue may be diffuse hyperplasia with Graves disease, its etiology. Also somebody thinks nodules may have autonomy function caused by hyperthyroidism. ( 3) acute, subacute thyroiditis induced hyperthyroidism: due to thyroid tissue by inflammatory damage, stored in in thyroid hormone is released to the blood, transient hyperthyroidism. ( 4) chronic lymphocytic thyroiditis with mastitis induced hyperthyroidism: thyroid autoimmune disease. When thyroid tissue damage, follicular rupture and release of thyroid hormones, can appear the symptom of thyrotoxicosis thyroid pathology, but there is diffuse lymphocytic infiltration, glandular atrophy and fibrous hyperplasia, last seen hypothyroidism ( hypothyroidism ), so this kind of hyperthyroidism is temporary, or false hyperthyroidism, appropriate symptomatic treatment. About 8% of Hashimoto's disease with thyroid hormones increase and symptoms of thyrotoxicosis. If the inhibit thyroid blocking antibodies ( Blocking antiboday ) is dominant, it will not appear in hyperthyroidism. ( 5) the iatrogenic hyperthyroidism hypothyroidism: some parents mistakenly believe that multiple medication can accelerate better, this taking too much thyroid tablets, so that the children appear thinner, palpitations, 成都甲亢医院
sweating, thyrotoxic manifestations. A child by its mother a medication 40 TabletsThyroid tablets, results of blood T3 reached 23.1mmol / L ( 15NG / DL ), 1.2-3.4mmol / L ( 0.8-2.2NG / DL ). Taking lithium carbonate can also be caused by hyperthyroidism, its mechanism and iodide induced hyperthyroidism: because of similar intrathyroidal iodine pool expanded after escape phenomenon, the results caused by hyperthyroidism. ( 6) radioiodine: using iodine as treatment or prophylaxis of endemic goitre can cause hyperthyroidism. Patients with normal thyroid function, but the autonomy of the nodule, and thus not subject to the regulation of the hypothalamic pituitary, so after taking iodine can cause hyperthyroidism. A few Graves patients after clinical cure of clothes can also make " recurrence of hyperthyroidism iodine ". Can also be found in non endemic multiple nodular goiter, autonomous adenoma patients and taking iodide, with lipiodol therapy patients. Radioiodine clinical symptoms of thyrotoxicosis, but thyroid iodine 131 ( 131 ) low rate. ( 7) caused by hyperthyroidism thyroid tumors: tumor tissue itself or its metastases can have the uptake and secretion of thyroid hormone function caused by hyperthyroidism. They use a number of iodine treatment and recovery. ( 8): neonatal hyperthyroidism hyperthyroidism in a pregnant woman blood is present in the LATS can be passed to the fetus through the placenta. The general was temporary, a few can be delayed for several years. The light without symptoms without treatment, patients showed extreme irritability, irritable, easy to hungry, skin flushing, respiration and heart rate, exophthalmos, goiter, sometimes can appear icteric, liver enlargement. ( 9) TSH increased type hyperthyroidism : also known as the TSH virus disease. Blood T3, T4 and TSH were increased, can have the following reasons:①pituitary tumours: increased TSH secretion, or ectopic tumors secreting TSH like substances, such as lung cancer, mole. Children rare. The selective pituitary unresponsiveness syndrome: should not belong to thyroid disease a, is hereditary. Blood T3 level, T4 is high but not negative feedback response, blood TSH still increased, and in other tissues of blood T3, T4 still has a reaction caused by hyperthyroidism. ③familial hyperthyroidism: anterior pituitary defect. The secretion of TSH cell deficiency 5 ' - deiodinase, T4 conversion T3 reduction, T3 nuclear receptor is not fully saturated, to reduce the secretion of TSH negative feedback effect is weakened, so TSH secretion is much, blood T3, T4 still increased, causing thyrotoxicosis. Also known as the syndrome of inappropriate secretion of pituitary TSH. Treatment of hyperthyroidism with T3, can be reduced. ( 10): hyperthyroidism complicated with other diseases can be associated with other endocrine diseases or autoimmune disease coexisting, such as multiple endocrine autoimmune syndrome complicated with: idiopathic Addison disease, hypoparathyroidism, diabetes mellitus, pernicious anemia, myasthenia gravis, lupus, rheumatoid arthritis. Also visible in the Down syndrome ( big event type) and multiple bone fibrous structures dysplasia. ( 11) T3 thyrotoxicosis hyperthyroidism: the only blood T3 and increased blood T4 normal. Often seen in early or recurrence of hyperthyroidism. ( 12) T4 thyrotoxicosis hyperthyroidism: the only 慈溪哪里有治疗甲亢的医院
blood T4 and increased blood T3 normal. Now that T3 thyrotoxicosis, T4 thyrotoxicosis are not independent of disease, but with some stage performance, simple blood T3 high or high level of plasma T4, or after treatment in the recovery process of the results. In addition to total T3 or T4 high is not necessarily sufficient hyperthyroidism, should check the free T3 ( FT3 ) and free T4 ( FT4 ), if there is increased to the diagnosis of hyperthyroidism. In 2, the clinical manifestations: ( 1) age and gender: pediatric patients suffering from hyperthyroidism hyperthyroidism cases accounted for about 5% of total, often seen in school age children. Tianjin Children's Hospital 184 cases of hyperthyroidism statistics, in 10 - 12 years old at most, a minimum of 5 months baby boy, whose mother had hyperthyroidism. The literature has born 2 weeks after the onset of its parent hyperthyroidism history. Tianjin infant school in 184 cases, male 30 cases, female 154 cases, male: female l:5.1, mostly female. ( 2) family history: hyperthyroidism often have family history, there have been four generations of a family suffering from hyperthyroidism report. Monozygotic twin suffered from hyperthyroidism can reach 30%-60%, fraternal 3% - 9%. Mode of inheritance may be autosomal dominant, also somebody thinks is more than genetic. Relationship between HLA remains to be studied. ( 3) symptoms and signs: symptoms appear gradually, from pathogenesis to treatment time is generally 6 - 12 months. ①sympathetic excitability increases, increased basal metabolic rate: in height more than age children, but have thin, succulent, afraid of heat, low fever. Appetite more excitement, defecate number increase but thick and. Palpitations, rapid pulse, apex can be heard systolic murmur, the pulse pressure is big, have high blood pressure, heart enlargement and heart rhythm disorders. Heart failure and atrial fibrillation in pediatric rare.慈溪甲亢在哪看
Shang Youyi is excited, active, excitement, insomnia, multilingual, grumpy, hand and tongue slight and rapid tremor and other neuropsychiatric symptoms. Muscle weakness, but periodic paralysis is rare. Osteoporosis can be accompanied by pain. Sexual development is slow, menstrual disorders, amenorrhea, oligomenorrhea. ②goiter: thyroid isthmus and the body swelling, can move up and down with the trachea. Diffuse enlargement gland smooth, soft, tremor, audible bruit. Nodular enlargement palpable and size a, qualitative hard, single or multiple nodules. There are few clinical hyperthyroidism goiter is not obvious, its reason is: the thyroid antibodies in a class is excited ( TSl ) or inhibition ( TSll ) antibody in patients with thyroid function: if at the same time excited only its functional antibodies and inhibits the growth of antibody, can appear less hyperthyroidism thyroid gland. Thyroid enlargement standard:Ⅰ degree diameter less than 3CM,Ⅱ3-5CMⅢ7CM, 5 - 7 - 9CM, IV, V degree greater than 9CM. More commonly in the second degree aⅢdegree. The ocular manifestations: 50% - 70% patients with proptosis, can be on one or both sides, palpebral fissure width, often do not blink, often look like, upper eyelid retraction, eye look down at the upper eyelid cannot fall immediately with the eyeball, upper eyelid ectropion difficulties, when closing eyes eyelid fibrillation, weak convergence, glance look, not wrinkled forehead skin pigmentation, eyelids, with ophthalmoplegia paralysis.