Endemic juvenile hypothyroidism in a severe endemic goitre area of Sudan

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.