Thyroid Disease in Adolescents

Abstract

A transient diffuse enlargement of the thyroid can occur during puberty. In countries with suffi cient availability of iodine, a diffuse enlargement of the thyroid can otherwise be caused by autoimmune thyroiditis. From a global perspective, iodine deficiency is the most common cause of goitre in adolescents.

Enlargement that affects only part of the thyroid should arouse suspicion of tumour.

Rarely occurring defects in enzymatic processes for synthesis of thyroid hormone or in the TSH receptor function can also cause dysfunction and/or increased size of the thyroid.

Investigation of goitre follows the same principles as in adults. Thyroid function is checked by analysis of TSH, T4 and T3. TPOAb may indicate autoimmune thyroiditis. Fine-needle biopsy for cytological diagnosis is used more rarely in children and adolescents, but is always indicated for the investigation of a palpable lump in the thyroid. A fine-needle biopsy should preferably be combined with and guided by ultrasound investigation.