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The course of Hashimoto’s thyroiditis in children is variable
The background of the study. Hashimoto’s thyroiditis is a common cause of thyroid disease in children, but relatively little is known about its natural history. This study was done to determine the course of Hashimoto’s thyroiditis in a large group of children who were euthyroid or had subclinical hypothyroidism at the time of diagnosis.
How the study was done. A total of 160 children (117 girls, 43 boys) with Hashimoto’s thyroiditis were followed at 20 centers in Italy. All had high serum concentrations of antithyroid peroxidase (anti-TPO) antibodies or antithyroglobulin (anti-Tg) antibodies, and serum thyrotropin (TSH) concentrations <2 times the upper limit of normal. Serum TSH, free thyroxine (T4), and anti-TPO and anti-Tg antibodies were measured at base line and during follow-up. Children with serum TSH concentrations >2 times the upper limit of normal at base line were treated with T4 and excluded, as were those whose serum TSH concentrations increased to this level during follow-up.
The results of the study. At the time of diagnosis, 105 children (66 percent) had normal serum TSH concentrations and 55 (34 percent) had high concentrations (<2 times the upper limit of normal). The height and body-mass index of the children in each group were normal for age and sex.
The median duration of follow-up was 5 years. Among the 160 children, the final serum TSH concentration was normal in 84 (53 percent), <2 times the upper limit of normal in 26 (16 percent), and >2 times the upper limit of normal in 50 (31 percent). The concentration increased to >2 times the upper limit of normal in 27 children (26 percent) of those with normal initial values and 23 (42 percent) of those with initial values <2 times the upper limit of normal.
Statural growth was normal during follow-up in all children, including those in whom serum TSH concentrations increased to >2 times the upper limit of normal.
The conclusions of the study. Among children with Hashimoto’s thyroiditis who have normal or slightly high serum TSH concentrations at diagnosis, the concentrations may increase, not change, or decrease with time.
The original article. Radetti G, Gottardi E, Bona G, Corrias A, Salardi S, Loche S; Study Group for Thyroid Diseases of the Italian Society for Pediatric Endocrinology and Diabetes (SIEDP/ISPED). The natural history of euthyroid Hashimoto’s thyroiditis in children. J Pediatr 2006;149:827-32.
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| Thyroid Digest Index | | | March 2007 Thyroid Digest |
