Background: Hashimoto thyroiditis (HT) is the most frequent acquired thyroid disease in childhood and adolescence. However it can evolve silently also for a long period, without signs and/or symptoms evocative of the diagnosis.
Objective and hypotheses: A late diagnosis can reduce growth velocity, increase weight and particularly BMI, with an increased risk of obesity in pubertal age.
Method: We analyzed 39 patients (age: 11.3±3.8 years; ten males; 29 females) with HT. All the patients during the follow up were euthyroid, with or without L-thyroxine treatment.
Results: At the first control only two patients had a BMI >2 SDS; only two had BMI <−2 SDS. During the follow up only one patient had a BMI <−2SDS and only one had a BMI >2 SDS. TSH was 7.52±12.75 at the first visit, fT3 was 5.2±2.64, fT4 was 3.21±4.80. TSH was directly correlated with SDS BMI, SDS weight. At the following visits (from the second to the seventh) TSH levels ranged between 3.03±2.44 and 2.28±1.60, with an adequate compliance to the treatment. SDS of stature and weight were inversely correlated to the age at the diagnosis, even without a statistically significant correlation. SDS of stature, weight and BMI at the first visit were directly and significantly correlated to the same measurements relieved at the following controls, without a worsening during the follow up, excluding any negative influences from the course of HT.
Conclusion: All the families received an adequate nutritional education, and the patients were trained to a program of physical activity 34 times/week, suitable with age and sex of the patients. We obtained an 80% of adherence and the maintenance of a SDS BMI adequate to age.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology