Correction of immunologic responsiveness as a part of comprehensive treatment in adolescents with unfavorable course of diffuse nontoxic goiter living under conditions of mild iodine deficiency
Journal Title: Український журнал дитячої ендокринології - Year 2018, Vol 0, Issue 1
Abstract
Objective — to determine the role of correction of immune status disorders in treatment of adolescents with unfavorable course of diffuse nontoxic goiter (DNG). Materials and methods. We have assessed somatic health status, thyroid and immune status of 202 boys and 198 girls with DNG, aged 10—17 years. The comparison group consisted of 100 virtually healthy people of the same age and 30 adolescents with ENT pathology and thyroid gland (TG) of normal size. During treatment of patients with unfavorable course of DNG and with ENT pathology we had applied basic therapy with potassium iodide medications and/or Lthyroxine in conjunction with immunomodulators. Results and discussion. As distinct from patients with pathology of ENT organs and TG of normal size, in patients with DNG and ENT pathology there is an imbalance of immunocompetent cells due to decreased percentage of СD3+ lymphocytes against the background of preservation of CD4/CD8+ lymphocyte ratio and disorder in oxygen-dependent processes of phagocytosis (decreased absorbing capacity of phagocytic cells, lower results of an induced NBT test with a decrease of metabolic reserve of neutrophils). It has been proved that differentiated therapy in patients with DNG and ENT pathology enables not only improvement of status of thyroid and immune systems, but a more positive prognosis for the course of goiter in adolescence as well. Conclusions. In patients with DNG and ENT pathology we have observed changes in cellular and phagocytic components of immunity. Imbalance of immunocompetent cells emerges against the background of disorders in oxygen-dependent processes of phagocytosis. Comprehensive application of basic therapy and immunomodulating drugs improves prognosis for the course of DNG in adolescence as a result of normalization of status of thyroid and immune systems.
Authors and Affiliations
S. I. Turchina, N. V. Shlyakhova
Keywords
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