ESPE Abstracts

Keywords: Hashimoto’s thyroiditis, autoimmune thyroiditis, hypothyroidism

Objective: In our study, it was aimed to determine the clinical course of the disease by evaluating the cases diagnosed with Hashimoto's thyroiditis (HT) periodically, clinically, laboratory, and radiologically.

Material and Method: Patients diagnosed with HT without chronic systemic disease, drug use history, and syndromic disease, who applied between 07.10.2019 and 15.03.2021, were included in this prospective study. The cases were divided into euthyroid, subclinical hypothyroidism, overt hypothyroidism, and hyperthyroidism groups at diagnosis and were followed up clinically, laboratory, and radiologically until the 18th month.

Results: Of the 35 cases with HT, 29 (82.9%) were female, 6 (17.1%) were male, the mean age was 12.5±3.64 (3.4-18) years, and 26 (74.3%) were pubertal. At diagnosis, 31.43% (n=11) euthyroid, 37.14% (n=13) subclinical hypothyroidism, 22.86% (n=8) overt hypothyroidism, 8.57% (n=3) hyperthyroidism were found.45.7% (n=16) of the cases were asymptomatic; goiter was present in 18 (51.4%) cases. Anti-TPO levels 5202.2±17843.8 IU/ml in 94.3% of cases (n=33), anti-Tg levels 165.1±192.5 IU/ml in 67.6% of cases (n=23) were positive. At diagnosis, height, height SDS, body weight (BW), BW SDS, BMI, BMI SDS, heart rate, systolic, diastolic blood pressure, goiter rate, anti-TPO, and anti-Tg positivity rate, and levels were similar in all groups. On ultrasonography, 82.4% parenchyma heterogeneity and 67.6% hypoechogenicity were found, which were similar between the groups. In the euthyroid group, 2 patients developed subclinical hypothyroidism (1 patient at 6 months, and 1 patient at 18 months), and 1 patient developed hyperthyroidism (at 3 months). Clinical, laboratory, and radiological findings were similar in diagnosis and follow-up in the euthyroid group. Levothyroxine (LT4) treatment was started in 22 (62.8%) of 35 cases (8 cases with overt hypothyroidism, 13 cases with subclinical hypothyroidism, and 1 case with euthyroidism). Clinical, laboratory, and radiological findings were similar in diagnosis and follow-up in both subclinical and overt hypothyroid groups. The anti-Tg positivity rate was statistically significantly decreased only in the subclinical hypothyroid group in the follow-ups after diagnosis (P=0.029).

Conclusion: It was seen that approximately half of the cases with HT were asymptomatic at diagnosis. Most of the cases (60%) were diagnosed with hypothyroidism, followed by euthyroidism and hyperthyroidism. All of the hypothyroid cases required treatment. It was determined that thyroid autoantibody levels fluctuated and although a decrease in thyroid volume was observed, this decrease did not reach the level of significancein the one-and-a-half-year follow-up in the treatment group.