الفهرس 
DedicationOnly 14 pages are availabe for public view
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Abstract
Goiter, or thyromegaly, is enlargement of thyroid gland. It is often the first sign of thyroid disease, so it could be the inlet of studying thyroid disorders. Goiter may be caused by various thyroid diseases either congenital or acquired. Congenital goiter may be due to dyshormonogenesis or Pendred syndrome, maternal intake of anti-thyroid drugs, while acquired goiter may be associated with hyperthyroidism as in autoimmune thyroid disorders (mostly Grave’s disease and Hashitoxicosis) and toxic thyroiditis, may be associated with hypothyroidism as in endemic goiter and cretinism, Hashimoto’s disease or it may be associated with euthyroidism as in simple (colloid) goiter and Hashimoto’s disease. Neck US is a widely used diagnostic tool in patients with goiter. It is useful in evaluating thyroid size and anatomy and detecting nodules and change in echogenicity. Color Doppler US on thyroid vasculature has a valuable role in diagnosis of cause of goiter. Aim of this study was to assess causes of goiter in children attending Assiut University Children Hospital in the duration of 18 months. This study included all children aged since birth up to 18 years old who attended Assiut University Children Hospital during the duration of the study with the exclusion of any patient with neck swelling other than goiter and those who refused participation in the study. Each child was subjected to: Full clinical history including personal history, age, sex, family history and history of manifestations suggesting congenital hypothyroidism, acquired hypothyroidism or hyperthyroidism, all cases were subjected to full clinical examinations including weight, height, and body mass index (BMI) was calculated. General examination was done including vital signs, pubertal stage according to Tanner staging, and full systemic examination. Thyroid gland examination including site, size, and consistency of the gland was done. The following investigations were done: Neck U\S. TSH and free T4. Thyroid auto-antibodies in indicated cases. Results showed that this study included 28 patients with goiter, their ages ranged from 2 days up to 17 years; they were 7 males and 21 females. They were grouped into 2 groups: First group: included those patients with congenital goiter, they were 5 patients, 4 patients of them was suggested to have dyshormonogenesis; 3 out of them were suggested to have Pendred syndrome, and 1 patient was suggested to have goiter due to maternal intake of anti-thyroid drug. Second group: included those patients with acquired goiter, they were 23 patients. They were grouped into 3 groups according to their clinical presentation and thyroid function: Patients had goiter with hyperthyroidism were 11 patients, 6 patients of them were suggested to have Grave’s disease Patients had goiter with hypothyroidism were 8 patients, 5 patients of them were suggested to have Hashimoto’s thyroiditis. Patients had goiter with euthyroidism were 4 patients, all of them were suggested to have simple goiter. Results of our study revealed: Goiter in children is more prevalent in females than males; about 3 folds more common in females. Acquired goiter is more prevalent than congenital goiter; according to our study 82% of cases had acquired goiter in our locality. Family history of thyroid disorders was positive all patients with congenital goiter included in our study. Goiter with hyperthyroidism (and mostly Grave’s disease) is the most common cause of acquired goiter in children in our locality according to our study. According to our study regarding acquired goiter: goiter with hypothyroidism is less common than goiter with hyperthyroidism, and mostly Hashimoto’s disease is the most common cause of acquired goiter with hypothyroidism.