Clinical and Laboratory Characteristics of Children and Adolescents with Hashimoto Thyroiditis at Diagnosis and During Follow-up
Abstract
Objectives: The aim of this study was to evaluate the clinical and laboratory findings of children and adolescents with Hashimoto thyroiditis (HT) at diagnosis and during follow-up.
Materials and Methods: Between January 2015 and January 2019, a total of 181 patients aged between 4 and 18 years who were followed in the pediatric endocrinology department were evaluated. All patients were evaluated at the time of diagnosis and during follow-up with the clinical, laboratory and radiological data.
Results: Female patients constituted 85% of all patients. Mean age at diagnosis was 13.4±3.2 years and 77% of patients were pubertal. The followup period was 22.5±10.3 months (4-54 months). At the time of diagnosis 35% of patients were euthyroid, 29% had subclinical hypothyroidism, 22% had overt hypothyroidism, 4% had subclinical hyperthyroidism and 10% had overt hyperthyroidism. The common complaints of the patients were fatigue (44%), hair loss (25%), constipation (23%) and goitre (21%). In the ultrasonographic imaging of the patients, nodule was detected in 13% of the patients. The frequency of nodules was higher in patients with euthyroidism. Increased size of the thyroid gland was common in patients with hyperthyroidism. In follow-up, nodule development was observed in 6% of patients. All patients with subclinical hyperthyroidism became euthyroid during follow-up. Hypothyroidism developed in 13% of euthyroid patients during follow-up. The most common concomitant diseases were polycystic ovary syndrome and vitiligo.
Conclusion: The admission of patients with HT is highly variable and clinical changes have continued during follow-up. Therefore these patients
should be followed closely from the diagnosis and attention should be paid to other related diseases.
Key Words: Hashimoto Thyroiditis, Euthyroidism, Subclinical Hyperthyroidism, Thyroid Function, Long-term Prognosis
Keywords
Hashimoto Thyroiditis, Euthyroidism, Subclinical Hyperthyroidism, Thyroid Function, Long-term Prognosis
References
- 1. Rallison ML, Dobyns BM, Keating FR, et al. Occurrence and natural history of chronic lymphocytic thyroiditis in chidhood. J Pediatr. 1975;86:675-682.
- 2. Setian NS. Hypothroidisim in children: diagnosis and treatment. J Pediatr. 2007;83:209-216.
- 3. Matsuoka N, Unger P, Ben-Nun A, et al. Thyroglobulin-induced murine thyoiditis assessed by intrathyroidal T cell receptor sequencing. J Immunol. 1994;152:2562-2568.
- 4. Kotani T, Umeki K, Hirai K, et al. Experimental murine thyroiditis induced by porcine thyroid peroxidase and its transfer by the antigen-specific T cell line. Clin Exp Immunol. 1990;80:11-18.
- 5. Davies TF. Pathogenesis of Hashimoto’s thyroiditis (chronic autoimmune thyroiditis). www.uptodate.com 2019.
- 6. Huber G, Staub JJ, Meier C, et al. Prospective study of the spontaneous course of subclinical hypothyroidism:prognostic value of thyrotropin, thyroid reserve and thyroid antibodies. J Clin Endocrinol Metab. 2002;87:3221- 3226.
- 7. World Health Organization. Indicators for assessing iodine deficiency disorders and their control programmes: report of a joint WHO/UNICEF/ ICCIDD consultation; 1993. https://www.who.int/nutrition/publications/ micronutrients/iodine_deficiency/WHO_NUT_93.1/en/
- 8. de Vries L, Bulvik S, Phillip M. Chronic autoimmune thyroiditis in children and adolescents: at presentation and during long-term follow-up. Arch Dis Child. 2009;94:33-37.
- 9. Lorini R, Gastaldi R, Traggiai C, et al. Hashimoto’s thyroiditis. Pediatr Endocrinol Rev. 2003;1 Suppl 2:205-11; discussion 211.
- 10. Markovic S, Kostic G, Igrutinovic Z, et al. Hashimoto’s thyroiditis in children and adolescents. Srp Arh Celok Lek. 2008;136:262-266.