The natural course of Hashimoto's thyroiditis in children and adolescents.

Abstract

OBJECTIVE: Hashimoto's thyroiditis (HT) is the most common cause of thyroid

disease in children and adolescents, but little is known about the long-term

follow-up of HT. The aim of this study was to analyze the clinical and laboratory

characteristics and to observe the natural course of HT in children and

adolescents. METHODS: We retrospectively reviewed 153 patients with HT diagnosed

before 18 years of age. Subjects were grouped into euthyroid, subclinical

hypothyroidism, overt hypothyroidism, and hyperthyroidism on the basis of the

thyroid function test. Of the 153 subjects, 133 were followed up (range 6

approximately 181 months) at our clinic every 6 months for evaluation of goiter

size, thyroid function, thyroid peroxidase antibodies (TPO Ab), and thyroglobulin

antibodies (TG Ab) serum concentration. RESULTS: Thyroid function tests at the

time of presentation revealed euthyroid in 72 patients (47.1%), subclinical

hypothyroidism in 48 (31.4%), overt hypothyroidism in 22 (14.4%), and

hyperthyroidism in 11 (7.2%). Serum TPO Ab and TG Ab significantly decreased in

the subclinical hypothyroidism group with levothyroxine treatment. Also, there

was a significant decrease in the mean serum TG Ab levels among the overt

hypothyroid patients during the follow-up period, although TPO Ab levels were not

significantly different when compared to their baseline TPO Ab levels.

CONCLUSION: Most children with HT were euthryoid and remained euthyroid during

follow-up. However, thyroid function should still be monitored periodically for

early detection and treatment of overt hypothyroidism. Our data also showed that

levothyroxine treatment may have beneficial effects on the thyroid antibody

titers.