Subclinical hyperthyroidism when presenting as initial manifestation of juvenile Hashimoto’s thyroiditis: first report on its natural history
| Autor: | Alessandro Mussa, Tommaso Aversa, Giuseppina Salzano, Mariella Valenzise, F. De Luca, Andrea Corrias, Malgorzata Wasniewska, Mariacarolina Salerno, Donatella Capalbo |
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| Přispěvatelé: | Aversa, T, Valenzise, M, Corrias, A, Salerno, Mariacarolina, Mussa, A, Capalbo, Donatella, Salzano, G, De Luca, F, Wasniewska, M. |
| Rok vydání: | 2014 |
| Předmět: |
Male
Thyroid Hormones endocrine system Pediatrics medicine.medical_specialty Adolescent endocrine system diseases Endocrinology Diabetes and Metabolism Natural history Endogenous subclinical hyperthyroidism Hashimotos' thyroiditis Hashitoxicosis Hyperthyroidism Autoantibodies Child Cross-Sectional Studies Female Follow-Up Studies Hashimoto Disease Humans Prognosis Prospective Studies Endocrinology Medicine (all) Hashimoto Thyroiditi Thyroiditis medicine Juvenile Subclinical infection business.industry Follow up studies Hashimoto's thyroiditis medicine.disease Diabetes and Metabolism Multicenter study Immunology subclinical hyperthyroidism business hormones hormone substitutes and hormone antagonists |
| Zdroj: | Journal of Endocrinological Investigation. 37:303-308 |
| ISSN: | 1720-8386 |
| DOI: | 10.1007/s40618-014-0054-0 |
| Popis: | BACKGROUND: Due to the lack of specific pediatric studies, no data are available about natural history of endogenous subclinical hyperthyroidism (SH) in childhood. AIMS: (a) To investigate for the first time the natural history of SH [suppressed thyrotropin (TSH) and normal free thyroxine free thyroxine (FT4) levels] when presenting as initial manifestation of Hashimoto's thyroiditis (HT) in childhood (group A); (b) to compare spontaneous evolution of HT-related SH with that observed in age-matched patients with HT-related frank hyperthyroidism (suppressed TSH and elevated FT4 levels), i.e., Hashitoxicosis Htx (group B). RESULTS: In the 11 patients of group A, TSH normalization spontaneously occurred 1-24 months after diagnosis, while in the 10 patients of group B it occurred 3-9 months after diagnosis, with no differences between the 2 groups in terms of time interval from entry to TSH normalization. In group A, this time interval was related to baseline thyroid peroxidase antibodies (r = 0.78, p = 0.04). During follow-up, eight patients of each group remained euthyroid, whereas two became hypothyroid (in both groups) and one developed Graves' disease (in group A). CONCLUSION: (a) HT should be included among the causes of endogenous SH in pediatric age; (b) in children with HT-related SH, spontaneous normalization of TSH levels occurs within the first 24 months after diagnosis, as well as in age-matched patients with Htx; (c) in both these conditions, a further deterioration of thyroid function might re-present in some patients during follow-up; (d) Ht-related SH and Htx might be possibly seen as different biochemical stages along the same continuum. |
| Databáze: | OpenAIRE |
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