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The natural history of the normal/mild elevated TSH serum levels in children and adolescents with Hashimoto's thyroiditis and isolated hyperthyrotropinaemia: a 3-year follow-up.
Clin Endocrinol (Oxf) 2012; 76(3):394-8CE

Abstract

OBJECTIVE

The natural history of Hashimoto's thyroiditis (HT) and isolated hyperthyrotropinaemia (IH) is not well defined. We therefore studied the natural course of patients with HT and IH and looked for possible prognostic factors.

DESIGN

This is retrospective cross-sectional study.

PATIENTS

Three hundred and twenty-three patients with HT (88 boys and 235 girls) and 59 with IH (30 boys and 29 girls), mean age 9·9 ± 3·8 years were included in the study. When first examined, 236 of the children with HT had a normal TSH (G0) and in 87, it was elevated but <100% of the upper limit (G1). All IH subjects had elevated TSH. Potential risk factors for thyroid failure were evaluated after 3 years and included the presence or familiarity for endocrine/autoimmune diseases, premature birth, signs and symptoms of hypothyroidism, TSH levels, antithyroid antibodies and thyroid volume.

RESULTS

HT: Of those with HT, 170 G0 patients remained stable, 31 moved to G1 and 35 to G2 (hypothyroidism). Thirty-six G1 children moved to G0, 17 remained stable and 34 moved to G2. Of patients with IH: 23 normalized, 28 remained stable and eight became overtly hypothyroid. In patients with HT, the presence of coeliac disease, elevated TSH and thyroid peroxidase antibodies (TPOAb) increased the risk of developing hypothyroidism by 4·0-, 3·4- and 3·5-fold, respectively. The increase in TSH levels during follow-up was strongly predictive of the development of hypothyroidism. In patients with IH, no predictive factor could be identified.

CONCLUSIONS

Coeliac disease, elevated TSH and TPOAb at presentation and a progressive increase in TSH are predictive factors for thyroid failure in HT patients.

Authors+Show Affiliations

Department of Paediatrics, Regional Hospital of Bolzano, via L. Boehler 5, Bolzano, Italy. giorgio.radetti@asbz.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21981142

Citation

Radetti, Giorgio, et al. "The Natural History of the Normal/mild Elevated TSH Serum Levels in Children and Adolescents With Hashimoto's Thyroiditis and Isolated Hyperthyrotropinaemia: a 3-year Follow-up." Clinical Endocrinology, vol. 76, no. 3, 2012, pp. 394-8.
Radetti G, Maselli M, Buzi F, et al. The natural history of the normal/mild elevated TSH serum levels in children and adolescents with Hashimoto's thyroiditis and isolated hyperthyrotropinaemia: a 3-year follow-up. Clin Endocrinol (Oxf). 2012;76(3):394-8.
Radetti, G., Maselli, M., Buzi, F., Corrias, A., Mussa, A., Cambiaso, P., ... Loche, S. (2012). The natural history of the normal/mild elevated TSH serum levels in children and adolescents with Hashimoto's thyroiditis and isolated hyperthyrotropinaemia: a 3-year follow-up. Clinical Endocrinology, 76(3), pp. 394-8. doi:10.1111/j.1365-2265.2011.04251.x.
Radetti G, et al. The Natural History of the Normal/mild Elevated TSH Serum Levels in Children and Adolescents With Hashimoto's Thyroiditis and Isolated Hyperthyrotropinaemia: a 3-year Follow-up. Clin Endocrinol (Oxf). 2012;76(3):394-8. PubMed PMID: 21981142.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The natural history of the normal/mild elevated TSH serum levels in children and adolescents with Hashimoto's thyroiditis and isolated hyperthyrotropinaemia: a 3-year follow-up. AU - Radetti,Giorgio, AU - Maselli,Mara, AU - Buzi,Fabio, AU - Corrias,Andrea, AU - Mussa,Alessandro, AU - Cambiaso,Paola, AU - Salerno,Mariacarolina, AU - Cappa,Marco, AU - Baiocchi,Michela, AU - Gastaldi,Roberto, AU - Minerba,Luigi, AU - Loche,Sandro, PY - 2011/10/11/entrez PY - 2011/10/11/pubmed PY - 2012/6/23/medline SP - 394 EP - 8 JF - Clinical endocrinology JO - Clin. Endocrinol. (Oxf) VL - 76 IS - 3 N2 - OBJECTIVE: The natural history of Hashimoto's thyroiditis (HT) and isolated hyperthyrotropinaemia (IH) is not well defined. We therefore studied the natural course of patients with HT and IH and looked for possible prognostic factors. DESIGN: This is retrospective cross-sectional study. PATIENTS: Three hundred and twenty-three patients with HT (88 boys and 235 girls) and 59 with IH (30 boys and 29 girls), mean age 9·9 ± 3·8 years were included in the study. When first examined, 236 of the children with HT had a normal TSH (G0) and in 87, it was elevated but <100% of the upper limit (G1). All IH subjects had elevated TSH. Potential risk factors for thyroid failure were evaluated after 3 years and included the presence or familiarity for endocrine/autoimmune diseases, premature birth, signs and symptoms of hypothyroidism, TSH levels, antithyroid antibodies and thyroid volume. RESULTS: HT: Of those with HT, 170 G0 patients remained stable, 31 moved to G1 and 35 to G2 (hypothyroidism). Thirty-six G1 children moved to G0, 17 remained stable and 34 moved to G2. Of patients with IH: 23 normalized, 28 remained stable and eight became overtly hypothyroid. In patients with HT, the presence of coeliac disease, elevated TSH and thyroid peroxidase antibodies (TPOAb) increased the risk of developing hypothyroidism by 4·0-, 3·4- and 3·5-fold, respectively. The increase in TSH levels during follow-up was strongly predictive of the development of hypothyroidism. In patients with IH, no predictive factor could be identified. CONCLUSIONS: Coeliac disease, elevated TSH and TPOAb at presentation and a progressive increase in TSH are predictive factors for thyroid failure in HT patients. SN - 1365-2265 UR - https://www.unboundmedicine.com/medline/citation/21981142/The_natural_history_of_the_normal/mild_elevated_TSH_serum_levels_in_children_and_adolescents_with_Hashimoto's_thyroiditis_and_isolated_hyperthyrotropinaemia:_a_3_year_follow_up_ L2 - https://doi.org/10.1111/j.1365-2265.2011.04251.x DB - PRIME DP - Unbound Medicine ER -