Îïàðèí Î.À., Õîìåíêî Ë.Î., ßðàíöåâà Í.À. Sonographic features of the
thyroid gland in students suffering from gastroesophageal reflux disease and
autoimmune thyroiditis
*228216*
Oparin O.A., Khomenko L.O., Yarantseva N.À.
Kharkiv Medical Academy of Postgraduate Education
Department of Therapy, Rheumatology and Clinical
Pharmacology
Sonographic features of the thyroid gland in students
suffering from gastroesophageal reflux disease and
autoimmune thyroiditis
Nowadays gastroesophageal reflux disease (GERD) is one of the most
common diseases among young people. In a significant percentage of cases, the
main problem of this disease constitutes in delayed and untimely diagnosis. At
the same time, one of the diseases with which GERD often co-occurs is autoimmune
thyroiditis. The incidence of GERD is on average 16.8% worldwide, 22.8% in
Europe, and 18.4% in Ukraine. Autoimmune thyroiditis occurs in 3-4% population
of the world. At the same time in Ukraine, AIT occurs in 3-11% of the
population. Both these diseases significantly weight and modify the clinical
picture of each other.
These pathologies do not lose their relevance for studying. This is due
to a number of reasons: a significant negative influence on the quality of
life, a high risk of complications, a long-term recurrent course of the disease.
This is particularly actual problem for young people, as the formation of
pathological conditions just begins among this category of population.
The purpose of the research: to study the features of the sonographic picture of
the thyroid gland amongst patients suffer from GERD with concomitant AIT.
Materials and methods. For research we have selected two groups of patients.
The first group consisted of 25 patients aged 18 to 25 years suffering from an
isolated non-erosive form of GERD. The second group included 23 patients aged
19 to 25 years, suffering from a non-erosive form of GERD in combination with
AIT. The control group consisted of 15 almost healthy people of the same age
and gender. Patients were underwent ultrasound examination of the thyroid gland
on a ULTIMA pro-30 apparatus (manufactured in Ukraine). Also all patients were
underwent a comprehensive examination according to the protocols of diagnosis
and treatment of GERD and AIT, that included all necessary clinical, laboratory
and instrumental methods of investigation.
The diagnosis was made according to ICD-10. Statistical processing of
data was carried out using the programs Microsoft Excel 2007 and Windows
STATISTIKA 6.0.
Results of the research. Through ultrasound examination of the thyroid gland
the following data was obtained:
- heterogeneous structure of the thyroid gland because of fibrous
inclusions as well as contraction of the capsule was identified among 90% of
the second group patients,
- 9% of patients showed single expended follicles in the thyroid gland
structure;
- in 3.5% of cases areas of reduced echogenicity were found;
- and an increase in the size of the thyroid gland was noted in 2% of
patients.
At the same time patients of the first group did not have any
sonographic changes from the thyroid gland. Wherein clear correlation
dependence was revealed between the degree of expression of the ultrasound
pattern of AIT and the severity of clinical manifestations of GERD.
Thus the more sonographic changes in the thyroid gland among patients of
the second group were observed, the more clinical manifestations of GERD and
duration period of exacerbation were registered. In this case main complaints
were: heartburn, especially after eating disorders and increasing in evening
and night time, discomfort or pain in esophagus. At the same time, there was no
reliable relationship between the degree of expression of the ultrasound
picture of AIT and the changes in the indicators of thyroid hormones in the
blood. This reliable relationship was registered only as the increasing of
anamnesis of the combined course of GERD and AIT more than 5 years.
Conclusions:
1. A clear correlation between
the degree of AIT severity, the duration of the course and the severity of the
clinical picture of GERD was established;
2. The obtained data testifies
the presence of common pathogenetic mechanisms that aggravate the course of
this comorbid pathology.
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