Clinical, laboratory and ultrasound characteristics of autoimmune thyroiditis in the children’s population of territories with the location of metallurgical enterprises

Introduction. The combination of iodine deficiency and the negative impact of environmental factors determines the pathomorphism of thyroid diseases, including autoimmune thyroiditis (AIT).

The purpose of the study was to establish clinical, laboratory, and ultrasound features of autoimmune thyroiditis in children living under the influence of metallurgical production.

Materials and methods. AIT children residing in the zone of influence of the enterprises of the metallurgical industry (one hundred two cases) and outside the exposure zone (46 people) underwent a comparative analysis of the results of clinical and laboratory research, ultrasound imaging of thyroid gland tissues. 

Results. During the period 2010–2020, the increase in the incidence of thyroiditis in the territory with metallurgical production enterprises exceeded the average indicator in the Perm region by 1.5 times. Children from the test group had concentrations of lead, manganese, nickel, chromium and zinc in their blood higher than the regional background level. These elevated concentrations were detected in them by 1.7–5.5 times more frequent than in their counterparts from the reference group.

The number of AIT cases elevated by 2 times in the exposed boys; diffuse lesions of the thyroid gland and combination of AIT with other diseases, by 1.3 times (р = 0.03–0.04). Levels of IgA and IgG in blood serum were by 2.7 times higher in the test group (р = 0.015–0.043); TSH contents, by 2.3 times higher (р = 0.096); free T4 contents, by 5.4 times lower (р = 0.057). 

Limitations of the study. Children living at the only one subject of the Russian Federation; a comparatively small sampling; selected study of compounds with direct thyreo-cytotoxic effects

Conclusions. Incidence of thyroid gland diseases and thyroiditis in territories with developed metallurgic industry is higher than on territories with a relative favorable sanitary-hygienic situation. Children with elevated contents of metals in their blood had disorders of thyroid and immune status, thyroid gland disease and concomitant damage to other systems in the body. The mathematical relationships indicate the possible influence of metals on the formation of AIT.

Compliance with ethical standards. The study program was approved by the ethics committee of the Federal Scientific Center “Medical and Preventive Health Risk Management Technologies” (protocol No. 3 dated of March 01, 2017). All patients their legal representatives were informed about the purpose of the study, and voluntary informed consent was obtained from legal representatives. 

Contribution of the authors:
Shtina I.E. — concept and design of the study, collection and processing of material, statistical processing, text writing;
Luzhetsky K.P. — text writing;
Valina S.L. — concept and design of the study, text writing;
Zenina M.T. — collection and processing of material, statistical processing;
Ustinova O.Yu. — text writing.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version. 

Acknowledgment. The study had no funding.

Conflict of interests. The author declares no conflict of interests.

Received: August 12, 2022 
Accepted: September 07, 2022
Published: December 12, 2022