ESPE Abstracts

Introduction: The evolution of Hashimoto Thyroiditis (HT) has been investigated by several studies both in pediatric and adult age. However, there are limited data on the progression of the disease from childhood to adulthood.

Objective: Aim of the study was to describe the evolution of thyroid function in children with HT from childhood to young adulthood.

Patients and Methods: The diagnosis of HT was defined by the presence of anti-thyroid peroxidase antibodies (AbTPO) and/or anti-thyroglobulin antibodies (AbTG), and the typical hypoechoic ultrasound pattern. Patients with chromosomal abnormalities were excluded. We reviewed the medical charts of 131 children (median age 10.5 (3.33-17.5) years, 104 females) seen for HT in 2006 at the Pediatric Endocrine Unit of the Pediatric Hospital Microcitemico in Cagliari. Personal, anamnestic, clinical and laboratory data reported during the first visit were collected as well as data referring to the follow-up and the last visit (median age: 18 (10.33-33.5) years). Then, we called back all these patients who had reached adult age by that time and for 50 of them we could collect data regarding their last endocrinological visit (median age: 25,25 (18,91-37,16) years, 39 female).

Results: Between the first and the last pediatric visit (median period of 7.33 (0.5-21) years), euthyroidism persisted in 82.5% of 80 patients with initial normal thyroid function. A progression toward subclinical hypothyroidism (SH) or overt hypothyroidism (OH) was observed in 5 and 11.25% of subjects, respectively. Amongst 33 patients with SH at first visit, 36.4% reverted to euthyroidism while 9.1% maintained their condition. Finally, 54.5% of them showed an evolution of SH to OH. Between the last pediatric visit and the last endocrinological visit (median period of 7.42 (0.42-17) years), 70.4% of 27 young adults were still euthyroid, while 25.9 % developed OH. Considering the median interval (14.25 (11.75-21.5) years) between the first pediatric visit and the last available endocrinological visit, 58.6% of 29 euthyroid children and adolescents were still in this condition as young adults while 38% have developed OH. In contrast, 82.4% of the 17 patients with initial SH developed OH.

Conclusions: In this group of pediatric HT patients euthyroidism was maintained in 82.5% during the pediatric age, in 70.4% during young adulthood and in 58.6% after a long-term follow-up. In the same period euthyroidism and SH progressed to OH in 38 and 82.4% of cases respectively.