ESPE Abstracts

Introduction: Hashimoto’s thyroiditis (HT) is one of the most common autoimmune diseases in childhood. Despite its frequency, there are still controversies concerning the spontaneous evolution and presentation in childhood. Aim and methods: this is a retrospective study aiming to evaluate clinical and hormonal features at diagnosis and auxological parameters after 3 years in subjects with Severe Autoimmune Hypothyroidism (SAH). We defined severe hypothyroidism as fT4 <5.5 pg/ml and TSH >30 mU/ml. Subjects’ characteristics with SAH (group A) were compared to those with HT subdivided in group B if TSH 10-30 mU/ml and fT4 normal or fT4 <5.5 pg/ml, group C if TSH 4,5-10 mU/l and fT4 normal and group D if TSH <4,5 mU/l and fT4 normal. Results: Mean features were reported in table.

In group A 58.7% referred symptoms of hypothyroidsm (Asthenia the most common, 40% in A, 11.5% in B, 5.3% in C and 4.7% in D, P<0.05 A vs B-C-D). In Group A 80% showed clinical signs as Goiter 51.9% in A, 19.2% in B, 17.8% in C and 12.5% in D, P<0.05 A vs B-C-D; Growth Delay 30.7% in A, 0% in B and C and 1.5% in D, P<0.05 A vs B-C-D. 72.9% of group A had a familiy history for autoimmune diseases, 59.9% for group B+C+D. At SAH diagnosis, group A presented a difference between Height and Target Height of -1.21 SDS (0.04 for group B+C+D), -0.92 after 2 years (66.6% of subjects) (0.01 for group B+C+D) and -0.68 after 3 years (80% of subjects) (0.01 for group B+C+D). Conclusions: The risk of developing SAH is greater in younger and prepubertal children, and they are more symptomatic. Family history for autoimmune diseases seems to be greater in subjects with SHA (Pediatricians should be aware of it and follow carefully screening programs). We detected growth impairment at diagnosis in SAH compared to HT, progressively improving.