Distribution, Clinical Features and Laboratory Findings of Hashimoto’s Thyroiditis in Prepubertal and Pubertal Patients
Öz
Aims:Hashimoto's thyroiditis (HT) is the most common cause of acquired hypothyroidism in childhood. This disease, which develops on an autoimmune basis, often appears in adolescence. However, in recent years, However, in recent years, cases diagnosed with this disease in prepubertal and infant period have been reported. This is considered to regarding early exposure to environmental factors that disrupt the endocrine system and trigger autoimmunity. We aimed to evaluate the distribution, clinical features, and laboratory findings of our patients diagnosed with Hashimoto's thyroiditis in our clinic in prepubertal and pubertal periods.
Material and Method:In the study, the cases diagnosed with Hashimoto's Thyroiditis in Ankara City Hospital Pediatric Endocrinology 5th outpatient clinic between August 2019 and May 2022 were divided into two groups prepubertal (Tanner stage 1) and pubertal (Tanner stage 2-3-4-5). The two groups were compared retrospectively in terms of clinical, laboratory, and ultrasound findings.
Results: The mean±SDS of 134 patients diagnosed with HT was 12.4±3.4 years. While 25% (n:33) of the cases were prepubertal, 75% (n:101) were pubertal. The cases' female/male ratio (F/M) was 4.1/1, F/M: 2.3/1 in the prepubertal period, and F/M: 5.3/1 in the pubertal period.
The euthyroid phase was detected most frequently in all cases at diagnosis. While the rate of euthyroid and subclinical hypothyroidism was the same in the prepubertal group, it was most detected in these two phases. In the pubertal group, it was mostly detected in the euthyroid phase. When we compared the prepubertal and pubertal groups, it was seen that subclinical hypothyroidism and hypothyroidism were most common in the prepubertal group. In contrast, subclinical hyperthyroidism and hyperthyroidism were more common in the pubertal group.
Conclusion:In our study, HT is more prevalent in boys at the prepubertal stage than in the pubertal stage.
While the patients in the prepubertal period applied in the hypothyroid phase, it was remarkable that the pubertal group had hyperthyroidism in their admissions.
Anahtar Kelimeler
Kaynakça
- Peters C. and Schoenmakers N. The Thyroid Gland,In: Dattani MT BC eds. B 7th edition. OS 2019: 310.
- Hansen PS, Brix TH, Iachine I, Kyvik KO, Hegedüs L. The relative importance of genetic and environmental effects for the early stages of thyroid autoimmunity: a study of healthy Danish twins. European Journal of Endocrinology. 2006;154 (1):29–38.
- Tomer Y, Huber A. The etiology of autoimmune thyroid disease: a story of genes and environment. Journal of Autoimmunity. 2009;32 (3–4):231–9.
- Burek CL, Talor M V. Environmental triggers of autoimmune thyroiditis. Journal of Autoimmunity. 2009;33 (3–4):183–9.
- Tanda ML, Piantanida E, Lai A, Lombardi V, Dalle Mule I, Liparulo L, et al. Thyroid autoimmunity and environment. Hormone and Metabolic Research. 2009;41 (06):436–42.
- Strieder TGA, Tijssen JGP, Wenzel BE, Endert E, Wiersinga WM. Prediction of progression to overt hypothyroidism or hyperthyroidism in female relatives of patients with autoimmune thyroid disease using the Thyroid Events Amsterdam (THEA) score. Archives of Internal Medicine. 2008;168 (15):1657–63.
- Brent GA. Environmental exposures and autoimmune thyroid disease. Thyroid : official journal of the American Thyroid Association. 2010 Jul;20 (7):755–61.
- Tang S, Yang M, Zhang D, Tong YJ, Xin Y. Clinical Characteristics and Follow-Up of 19 Children With Hashimoto’s Thyroiditis Aged Below 3 Years: A Single-Center Retrospective Analysis. Frontiers in Endocrinology. 2021;12 (September):1–8.
- Caturegli P, De Remigis A, Rose NR. Hashimoto thyroiditis: clinical and diagnostic criteria. Autoimmunity Reviews. 2014;13 (4–5):391–7.
- Aversa T, Valenzise M, Corrias A, Salerno M, Mussa A, Capalbo D, et al. Subclinical hyperthyroidism when presenting as initial manifestation of juvenile Hashimoto’s thyroiditis: first report on its natural history. Journal of Endocrinological Investigation. 2014;37 (3):303–8.