Endemic juvenile hypothyroidism in a severe endemic goitre area of Sudan

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Abstract
Summary: OBJECTIVE The aim of the study was to assess thyroid function, Iodine Intake and exposure to dietary goitrogens of children living in an area with a high prevalence of goitre, in the region of Darfur, Sudan.DESIGN In a village where goitre affected approximately 85% of children, a cross‐sectional survey of thyroid function was performed in children 0–7 years old.PATIENTS Twenty neonates and 190 children, aged 1 month to 7 years, were included.measurements Thyroid hormones, urinary iodide and thiocyanate excretion were measured.RESULTS MeanSD serum T4 was below the normal range at birth (82 ± 50 nmol/l) and in the age group less than 2 years (73·46). Children older than 2 years had even lower serum 14: 37·37 (P >0 001) at 3–4 years and 36·38 (P >0 001) at 5–7 years. Mean serum TSH was 25 8(6 2–107 7) mU/I at birth, 8.3(2. 5–27. 8) In the group less than 2 years, 15. 3(2.9–79.1) at 3–4 years and 16. 4(2.7–98.3) at 5–7 years. The overall prevalence of hypothyroidism (TSH>50 mU/I) was 24%. Mean urinary thiocyanate was high at birth(107·69 pmol/l), normal in the group less than 2 years and higher in children older than 2 years (126·69 pmol/l) (P > 0.001). All age groups had a low urinary iodide concentration.CONCLUSION Hypothyroidism was very frequent in each age group. The higher frequency of hypothyroidism observed in weaned children (< 2 years) was attributed to the combined effects of Iodine deficiency and goitrogens (thiocyanate and glycosylflavones) derived from millet.