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Introduction L’hyperthyroidie est rare chez l’enfant, la maladie de Basedow (MB) est sa principale etiologie. Son traitement dans sa cette population particuliere est toujours un sujet de controverse. Nous essayons a travers ce travail de demontrer la place de l’iratherapie dans la MB de l’enfant. Methodes Il s’agissait d’une etude retrospective ayant porte sur 33 patients âges de moins de 19 ans, qui nous ont ete adresses pour iratherapie dans le cadre d’une maladie de Basedow sur la periode 2007–2015. Un recueil des donnees cliniques, biologiques et evolutifs a ete fait. Resultats Le sex-ratio F/M = 7,25. La moyenne d’âge etait de 16,87 ± 2,2 ans. La scintigraphie thyroidienne faite 24 h apres la dose traceuse d’iode131, confirme le diagnostic de MB. Les doses d’iode administrees etaient forfaitaires variant de 260 a 555 MBq. L’hypothyroidie post-radique etait obtenue dans 100 % des cas, le delai moyen de reponse etait de 3,27 mois (1 a 6 mois). Un seul cas de recidive de l’hyperthyroidie etait note a 1 an, ayant necessite une 2e cure avec installation d’une hypothyroidie post-radique au bout de 2 mois. Discussion et conclusions L’hyperthyroidie touche surtout le grand enfant avec une predominance feminine. Il est peut-etre temps de mettre le point sur l’importance et la necessite de l’utilisation de l’iode 131 dans son traitement d’autant plus que les autres modalites therapeutiques ne sont pas denuees d’effets indesirables et de complications.

No Abstract. Journal Tunisien d\'ORL et de chirurgie cervico-faciale Vol. 17 2006: pp. 16-18

The incidence of thyroid papillary microcarcinoma appears to be increasing and therapeutic modalities remain controversial. This retrospective study concerns 25 cases, from 1978 to 1999. The circumstances of diagnosis were: a cervicotomy for thyroid nodule (88% of cases), cervical node metastases (8%), and osseous metastases (4%). The sensitivity of ultrasounds was 22.2%, that of scintigraphy was 9.1% and that of extemporaneous histological examination was 18.2%. Multifocality was found in 16% of cases and bilaterality in 16.6%. Treatment modalities were guided by histological examination. Adjunctive radioiodine ablation was used for 20% of the patients. The treatment of the osseous metastases was completed with external irradiation. The average follow up was 4.8 years (4 months to 19 years), with a rate of survival without disease of 100%.

Perfusion lung scintigraphy is vital to guide the diagnosis even without a ventilation scintigraphy. A customised strategy could be useful to optimise the use of perfusion scintigraphy when not coupled with a ventilation scintigraphy. We report about a retrospective study on 300 patients received in our department for suspected lung migrations. The patients underwent a perfusion scintigraphy only: a normal scintigraphy would discard the diagnosis when achieved between 6 and 72 hours after the accident. On the other hand, the evidence of one or two perfusion defects would allow to maintain the pulmonary embolism suspicion and establish an effective heparinic treatment. A second control comparative scintigraphy, a few weeks after the first one, very often confirms the diagnosis, allows the assessment of the heparinotherapy and if necessary, indicate to stop it.

To report the results of seric neuron specific enolase in pediatric neuroblastoma.Our retrospective study concerns 21 children treated in our institution from 1992 to 1998 for neuroblastoma. Seric NSE was determined by immunoenzymology technique at different stages of the disease and the treatment.Mean value for the 39 dosages of the whole patients was 127.9 ng/ml with a sensitivity of 56%, five patients has presented normal values. Mean value for the 18 patients in stage IV was 132.38 ng/ml. We also observed in 3 patients, an evolution of the seric NSE parallel to this of the disease under chemotherapy.NSE represents a moderate sensitive and specific tumor marker for pediatric neuroblastoma. However, it represents a good value in prognosis and follow-up after chemotherapy.