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Alteraciones por deficiencia de yodo y bocio endémico en los escolares de Navarra
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The most recent information about endemic goitre in Navarra dates back to 1970. Al the studies carried out then point to the region as an important focus of endemic goitre. The present work was undertaken in order to find out the prevalence of goitre and the present state of disorders due to iodine deficiency in Navarra. A study was made of 7934 schoolchildren (9% of the total school population in 1985), and 13,4% of the children were found to have goitre. No cases of visible goitre were found (grade II or higher). Goitre was more frequent in girls tan in boys. endemic goitre was localized in the North-West región (17,8%), in Estella (15%) and in valley of the Pyrenees of Navarra (20,5%). The average excretion of iodine in the urine was 89 +45 mcg/L, 19,8% of the children being found with a urinary excretion of iodine of less tan 50 mcg/l.
A statistical relationship was found between the prevalence of goitre, urinary excretion of iodine and TSH. This relationship could not be established between the prevalence of goitre and average levels of T4.
These results confirm the existence of áreas of goitre in Navarra and thst the condition is slight, of a lesser degree tan that described in previous studies, the most important etiopathogenic factor being iodine deficiency.
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Therapy with anti-thyroid drugs is the initial option mostly used in our country for the treatment of hyperthyroidism due to Graves-Basedow disease. To evaluate the long term results of this kind of therapy, a total of 773 patients were studied who were diagnosed from 1975 to 1994 in three hospitals in Northern Spain (Hospital Central de Asturias, Hospital de Cruces and Hospital de Navarra) after a mean follow-up time after anti-thyroid drug withdrawal of 46 ± 33.1 months. The results showed a likelihood of hyperthyroidism relapse of 42.9%, 59.8%, 67.9% and 78.9% at one, three, five and ten years, respectively. Goitre size was correlated very significantly with the likelihood of relapse (p < 0.0001). In contrast, only TBII positivity at the end of therapy among the remaining parameters (age, sex, goitre size, length of therapy, positivity of anti-thyroid antibodies and TBII) influenced significantly on the relapse likelihood (p < 0.05). In conclusion, after a long term follow-up after anti-thyroid therapy, a high relapse rate of hyperthyroidism in Graves-Basedow disease, which amounts up to 79% at ten years, was observed. Goitre size was the main predictive factor for this relapse.
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