Long-Term Follow-Up and Outcomes of Autoimmune Thyroiditis in Childhood

Autor: Ghadir Elias-Assad, Osnat Admoni, Yardena Tenenbaum-Rakover, Tal Almagor, Shoshana Rath
Jazyk: angličtina
Rok vydání: 2020
Předmět:
0301 basic medicine
Male
Pediatrics
Goiter
endocrine system diseases
Endocrinology
Diabetes and Metabolism
Thyroid Gland
Thyroid Function Tests
lcsh:Diseases of the endocrine glands. Clinical endocrinology
0302 clinical medicine
Endocrinology
autoimmune thyroiditis (AIT)
Medicine
Compensated Hypothyroidism
Euthyroid
Child
Subclinical infection
Original Research
goiter
Hashitoxicosis
Prognosis
Anti-thyroid autoantibodies
Child
Preschool
Female
hormones
hormone substitutes
and hormone antagonists
medicine.drug
Adult
medicine.medical_specialty
endocrine system
Thyroid Hormones
Adolescent
Levothyroxine
030209 endocrinology & metabolism
Autoimmune thyroiditis
03 medical and health sciences
Young Adult
Hashimoto's thyroiditis
Hypothyroidism
Humans
Retrospective Studies
lcsh:RC648-665
business.industry
Thyroiditis
Autoimmune
medicine.disease
thyroid autoantibodies
Thyroxine
030104 developmental biology
business
Biomarkers
Follow-Up Studies
Zdroj: Frontiers in Endocrinology
Frontiers in Endocrinology, Vol 11 (2020)
ISSN: 1664-2392
Popis: Background: Autoimmune thyroiditis (AIT) is the most common cause of acquired hypothyroidism in children. The natural outcome of AIT in childhood has been reported previously however follow-up duration is generally short and results variable. Objectives: To characterize clinical and biochemical findings at presentation of AIT, evaluate long-term outcomes and assess which factors at presentation predict evolution over time. Study cohort: 201 children under 18 years of age at presentation (82% female) were enrolled. Subjects were divided into five subgroups according to thyroid stimulating hormone (TSH) level at referral. Results: Mean follow-up was 8.1 years (range 0-29 years). At presentation, 34% of patients had overt hypothyroidism, 32% subclinical hypothyroidism (SCH), 16% compensated hypothyroidism, 14% were euthyroid, and 3.7% had Hashitoxicosis. Children with overt hypothyroidism were younger (10.6 vs. 13.2 years) and had higher thyroid peroxidase antibody titers. At the time of the study, levothyroxine (LT4) therapy was required in 26% of children who were euthyroid at presentation, 56% of SCH patients, 83-84% of those with TSH above 10 mIU/L, and 57% of those with Hashitoxicosis. Over the years, 16% of children presenting with overt hypothyroidism stopped therapy. Free T4 at presentation was the only predictor of outcome over time. Conclusions: Our findings suggest that only 26% children who were euthyroid at presentation developed hypothyroidism, whereas over 50% of those with SCH went on to require treatment. Of those presenting with overt hypothyroidism, 16% recovered with time. The only predictive parameter for LT4 therapy at the end of the study was free T4 levels at presentation. Long-term follow-up is required to determine ongoing therapy needs and screen for additional autoimmune diseases.
Databáze: OpenAIRE
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