Background: It had never been investigated to now whether the course of thyroid function in Hashimotos thyroiditis (HT) may differ in the children who had presented with either euthyroidism or subclinical hypothyroidism (SH).
Objective and hypotheses: To establish, by means of a 5-year prospective evaluation of 234 children with HT and no prognostic risk factors, whether thyroid status evolution over time may be conditioned by the biochemical pattern at HT diagnosis.
Method: From the time of recruitment all of them were followed-up as outpatients every 12 months for a pre-established period of 5 years and only those who completed the overall follow-up period were taken into consideration for this study. At each examination TSH, FT4, thyroid peroxidase and thyroglobulin (TPOAb and TGAb) serum levels were measured.
Results: In the entire series TSH values significantly increased during follow-up, whilst FT4 values decreased and the proportion of children with a thyroid dysfunction increased from 27.3 to 47.4% (P=0.0001). Such a trend was more evident in the patients presenting with SH (group B) than in those presenting with euthyroidism (group A). At the end of follow-up the prevalence of children with overt hypothyroidism was 12.3% in group A vs 31.2% in group B (P=0.0007). TPOAb and TGAb serum levels at entry were not significantly different in the patients who deteriorated over time thyroid function than in those who did not.
Conclusion: a) children with HT are per se incline to show, during the first 5 years of disease, a spontaneous deterioration of thyroid function picture; b) such a trend is more evident in the patients who had presented with a SH than in those who were initially euthyroid; c) this trend is not significantly affected by the serum levels of TPOAbs and TGAbs at HT diagnosis.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology