Background: Hashimotos thyroiditis is a common autoimmune disease in pubertal and adolescent girls. In the past years the incidence of this autoimmune disease of the thyroid gland has increased.
Objective and hypotheses: We present a 12.5 year old girl who had her first visit at our Pediatric Endocrinology Department at the age of 10 years due to short stature and clinical signs of hypothyroidism. Her height was 3SD SDS and her BMI was 12.7. The initial clinical examination showed an enlarged and firm thyroid gland. The ultrasound of the thyroid gland was consistent with Hashimotos thyroiditis.
Method: Levels of thyroid hormones and anti-TPO antibodies were measured. Her thyrotropin levels were >75.0 μIU/ml (0.4004.5 μIU/ml). Her thyroid peroxidase antibodies were >1000 IU/ml (1050 IU/ml) and total T4 levels were 87.1 μmol/l (71.2141 umol/l). Her bone age was appropriate for an 8 year old, she also had a normochromic anemia and hyperlipidemia.
Results: Treatment was started with L-thyroxine 100 μg/m2 and 6 months after the commencing of the treatment the thyroid hormone levels normalized, even though the level of the anti-TPO antibodies remained elevated. She started to grow and her height reached μ1.5 S.D. After 2 years of treatment her height is within normal range (+1.0 S.D.)
Conclusion: The regular follow-up continues for possible further complications.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology