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The natural history of euthyroid Hashimoto's thyroiditis in children.
J Pediatr 2006; 149(6):827-32JPed

Abstract

OBJECTIVE

To study the natural history of Hashimoto's thyroiditis (HT) in children and identify factors predictive of thyroid dysfunction.

STUDY DESIGN

We evaluated 160 children (43 males and 117 females, mean age 9.10 +/- 3.6 years, with HT and normal (group 0; 105 patients) or slightly elevated (group 1; 55 patients) serum thyroid-stimulating hormone (TSH) concentrations. The patients were assessed at presentation and then followed for at least 5 years if they remained euthyroid or if their TSH did not rise twofold over the upper normal limit.

RESULTS

At baseline, age, sex, thyroid volume, free thyroxine, free triiodothyronine, thyroid peroxidase antibody (TPOab), and thyroglobulin antibody (TGab) serum concentrations were similar in the 2 groups. During follow-up, 68 patients of group 0 remained euthyroid, and 10 patients moved from group 0 to group 1. In 27 patients, TSH rose twofold above the upper normal limit (group 2), and 9 of these patients developed overt hypothyroidism. Sixteen patients of group 1 ended up in group 0, 16 remained in group 1, and 23 moved to group 2. A comparison of the data of the patients who maintained or improved their thyroid status with those of the patients whose thyroid function deteriorated revealed significantly increased TGab levels and thyroid volume at presentation in the latter group. However, none of these parameters alone or in combination were of any help in predicting the course of the disease in a single patient.

CONCLUSIONS

The presence of goiter and elevated TGab at presentation, together with progressive increase in both TPOab and TSH, may be predictive factors for the future development of hypothyroidism. At 5 years of follow-up, more than 50% of the patients remained or became euthyroid.

Authors+Show Affiliations

Department of Pediatrics, Regional Hospital, Bolzano, Italy. giorgio.radetti@asbz.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

17137901

Citation

Radetti, Giorgio, et al. "The Natural History of Euthyroid Hashimoto's Thyroiditis in Children." The Journal of Pediatrics, vol. 149, no. 6, 2006, pp. 827-32.
Radetti G, Gottardi E, Bona G, et al. The natural history of euthyroid Hashimoto's thyroiditis in children. J Pediatr. 2006;149(6):827-32.
Radetti, G., Gottardi, E., Bona, G., Corrias, A., Salardi, S., & Loche, S. (2006). The natural history of euthyroid Hashimoto's thyroiditis in children. The Journal of Pediatrics, 149(6), pp. 827-32.
Radetti G, et al. The Natural History of Euthyroid Hashimoto's Thyroiditis in Children. J Pediatr. 2006;149(6):827-32. PubMed PMID: 17137901.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The natural history of euthyroid Hashimoto's thyroiditis in children. AU - Radetti,Giorgio, AU - Gottardi,Elena, AU - Bona,Gianni, AU - Corrias,Andrea, AU - Salardi,Silvana, AU - Loche,Sandro, AU - ,, PY - 2005/12/13/received PY - 2006/04/25/revised PY - 2006/08/19/accepted PY - 2006/12/2/pubmed PY - 2007/2/23/medline PY - 2006/12/2/entrez SP - 827 EP - 32 JF - The Journal of pediatrics JO - J. Pediatr. VL - 149 IS - 6 N2 - OBJECTIVE: To study the natural history of Hashimoto's thyroiditis (HT) in children and identify factors predictive of thyroid dysfunction. STUDY DESIGN: We evaluated 160 children (43 males and 117 females, mean age 9.10 +/- 3.6 years, with HT and normal (group 0; 105 patients) or slightly elevated (group 1; 55 patients) serum thyroid-stimulating hormone (TSH) concentrations. The patients were assessed at presentation and then followed for at least 5 years if they remained euthyroid or if their TSH did not rise twofold over the upper normal limit. RESULTS: At baseline, age, sex, thyroid volume, free thyroxine, free triiodothyronine, thyroid peroxidase antibody (TPOab), and thyroglobulin antibody (TGab) serum concentrations were similar in the 2 groups. During follow-up, 68 patients of group 0 remained euthyroid, and 10 patients moved from group 0 to group 1. In 27 patients, TSH rose twofold above the upper normal limit (group 2), and 9 of these patients developed overt hypothyroidism. Sixteen patients of group 1 ended up in group 0, 16 remained in group 1, and 23 moved to group 2. A comparison of the data of the patients who maintained or improved their thyroid status with those of the patients whose thyroid function deteriorated revealed significantly increased TGab levels and thyroid volume at presentation in the latter group. However, none of these parameters alone or in combination were of any help in predicting the course of the disease in a single patient. CONCLUSIONS: The presence of goiter and elevated TGab at presentation, together with progressive increase in both TPOab and TSH, may be predictive factors for the future development of hypothyroidism. At 5 years of follow-up, more than 50% of the patients remained or became euthyroid. SN - 0022-3476 UR - https://www.unboundmedicine.com/medline/citation/17137901/The_natural_history_of_euthyroid_Hashimoto's_thyroiditis_in_children_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3476(06)00798-0 DB - PRIME DP - Unbound Medicine ER -