Cases of Goiter in Children Attending Assiut University Children Hospital

Congenital goiter most commonly occurs in neonates born to mothers with known thyroid disease especially Graves' disease. Other causes of congenital goitrous hypothyroidism are thyroid dyshormonogenesis, endemic iodine deficiency and maternal goitrogen ingestion or iodine excess (expectorants, povidone iodine).

The most common causes of euthyroid goiter in childhood are chronic lymphocytic thyroiditis and a colloid goiter (simple goiter). Thyroid enlargement that is not caused by inflammatory, infectious or neoplastic causes is termed a colloid goiter, also.

Chronic lymphocytic thyroiditis , also known as Hashimoto thyroiditis, is an autoimmune, inflammatory process that causes up to 55% to 65% of all euthyroid goiters, and almost all cases of thyroiditis in childhood and adolescence. A large North American prevalence study showed that as many as 1.2% of children aged 11 to18 years have chronic lymphocytic thyroiditis, as defined by an enlarged thyroid gland and detectable serum thyroid antibodies.

Thyroid nodules are relatively common in adolescents; these nodules are usually asymptomatic and often discovered incidentally, but they raise the fear of cancer. A multi-nodular goiter is almost invariably caused by Hashimoto's thyroiditis and it carries a good prognosis. The asymptomatic, solitary thyroid nodule is a thyroid adenoma, thyroid carcinoma or a thyroid cyst. Thyroid carcinoma occurs in approximately one per one million persons/year in the first-two decades of life.

No reported data are found as regard of causes of goiter in children in our locality.