الفهرس 
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Abstract
Thyroid gland diseases are the second most frequent endocrinopathies in children and adolescents with girls being more frequently affected. It is amultidisciplinary problem requiring co operation of specialists in different fields of medicine. In patients with thyroid gland diseases not responding to conservative treatment the surgery is the causal therapy.
Congenital Hypothyroidism (CH) is one of the most common preventable causes of mental retardation with a worldwide incidence of 1:4000 live births. Ideally universal screening at 3-4 days of age should be done for detecting CH. Abnormal values on screening (T4 < 6.5 ug/dL, TSH > 20mu/L) should be confirmed by a venous sample before initiating treatment. Term as well as preterm infants with low T4 and elevated TSH should be started on L-thyroxine at a dose of 10-15μg/ kg/ day as soon as the diagnosis is made. Regular monitoring should be done to ensure that T4 is in the upper half of normal range. The outcome of CH depends on the time of initiation of therapy and the dose of L-thyroxine used with the best outcome in infants started on treatment before 2 weeks of age.
Hyperthyroidism is a relatively rare condition in children. The vast majority of cases are caused by Grave`s disease. Numerous therapeutic options are available, and most patients do well, although the risk of relapse or subsequent hypothyroidism is substantial. In atypical cases, consider that a small number of patients may have hyperthyroidism due to other causes. It is treated first with medical treatment and if not respond it is treated surgical.
The broad category of thyroiditis includes the following inflammatory diseases of the thyroid gland: (1) acute suppurative thyroiditis, which is due to bacterial infection; (2) subacute thyroiditis, which results from a viral infection of the gland; and (3) chronic thyroiditis, which is usually autoimmune in nature. In childhood, chronic thyroiditis is the most common of these 3 types. The second form of thyroiditis, Riedel struma, is rare in children.
Thyroid nodules are common, and with the increasing use of ultrasound for unrelated problems are detected with greater frequency. The aim of management is to identify which nodules warrant further investigation to exclude the presence of malignancy. Although a thorough history and clinical examination are indispensable, FNAB is essential to decision making and is able to provide highly accurate information that will ultimately determine the management of a nodule
Conclusion: Treatment of grave`s disease initiate with antithyroid medications as recommended by Most pediatric endocrinologists. Chronic lymphocytic or autoimmune thyroiditis (Hashimoto`s thyroiditis) mostly presents with a painless homogeneous goiter which is the commonest cause of goiter in children.