scholarly journals Retrospective Analysis of Hashimoto’s Thyroiditis in Children and Adolescents: A Single Center Experience

2021 ◽  
Author(s):  
Selma Tunç ◽  
Behzat Özkan
Keyword(s):  
Celiac Disease ◽  
Autoimmune Diseases ◽  
Children And Adolescents ◽  
Subclinical Hypothyroidism ◽  
Hashimoto’S Thyroiditis ◽  
Hashimoto's Thyroiditis ◽  
Overt Hypothyroidism ◽  
Healthy Children ◽  
Thyroid Ultrasonography

Objective: Hashimoto’s thyroiditis is an organ-specific autoimmune disease and the most common cause of goiter and acquired hypothyroidism in children and adolescents in regions devoid of endemic iodine deficiency. In this study, it was aimed to examine the epidemiological, clinical and laboratory features of Hashimoto’s thyroiditis and autoimmune diseases accompanying Hashimoto’s thyroiditis in children and adolescents. Methods: We retrospectively examined thyrotropin, free thyroxin, thyroid autoantibodies (thyroid peroxidase and thyroglobulin antibodies), immunoglobulin A (IgA), anti-tissue transglutaminase antibodies (IgA-tTG), and thyroid ultrasonography findings of 108 cases aged 5-18 years with positive anti-thyroid antibodies. Results: The female/male ratio was 80/28 and 68% of the patients were adolescents. The most common admission complaint was goiter. At the time of diagnosis, the cases had euthyroidism (44.4%), subclinical hypothyroidism (35%), overt hypothyroidism (16.6%), and hyperthyroidism (3.7%). Goiter was detected in 58 (53.7%) cases by thyroid ultrasonography. During the follow-up, overt hypothyroidism developed in 6 patients who had subclinical hypothyroidism and subclinical hypothyroidism developed in 8 patients who had euthyroidism. All patients with hyperthyroidism became euthyroid. Levothyroxine treatment was administered to 47 (43.5%) patients. Celiac disease was detected in 2 and type 1 diabetes mellitus in 1 patient. Conclusions: The prevalence of Hashimoto’s thyroiditis increases with age both in childhood and adolescence, and thyroid functions tend to deteriorate over time. Therefore, close follow-up and appropriate treatment are important. Although the prevalence of celiac disease is higher in children and adolescents with Hashimoto’s thyroiditis compared to healthy children, the true prevalence of autoimmune diseases accompanying Hashimoto’s thyroiditis will be revealed in studies to be conducted in larger patient populations.

scholarly journals Clinical Characteristics and Follow-Up of 19 Children With Hashimoto’s Thyroiditis Aged Below 3 Years: A Single-Center Retrospective Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Shi Tang ◽  
Min Yang ◽  
Dan Zhang ◽  
Ya-jie Tong ◽  
Ying Xin
Keyword(s):  
Early Diagnosis ◽  
Developmental Delay ◽  
Thyroid Function ◽  
Subclinical Hypothyroidism ◽  
Hashimoto’S Thyroiditis ◽  
Clinical Characteristics ◽  
Diagnosis And Treatment ◽  
Hashimoto's Thyroiditis ◽  
Global Developmental Delay

AimTo analyze the clinical characteristics of Hashimoto’s thyroiditis (HT) in children below 3 years of age in order to improve the understanding of the disease, avoid misdiagnosis, and achieve early diagnosis and treatment.MethodsThe study retrospectively analyzed the clinical data of 19 patients diagnosed with HT in the first three years of life.ResultsThe patients (12 female, 7 male) had an average age of 26.1 ± 8.2 months (range 10–36 months). At presentation, one patient had euthyroidism, ten had hypothyroidism, seven had subclinical hypothyroidism, and one had hyperthyroidism. The most common reasons for doctor’s visits were thyroid enlargement (21.1%), global developmental delay (21.1%), and routine thyroid function tests in patients with type 1 diabetes (26.3%). Sixteen patients provided follow-up data, and the mean follow-up time was 23.31 ± 16.44 months (range 1–48 months). In the hypothyroidism group, one patient stopped levothyroxine (LT4) treatment after 2 months; the remaining patients had been treated with LT4 since their diagnosis. In the subclinical hypothyroidism group, one patient whose thyroid function returned to normal after 1 month of being diagnosed was not treated. The remaining patients received LT4 treatment at their diagnosis or during follow-up. The patient with hyperthyroidism was treated with methimazole after diagnosis, but treatment was discontinued 11 months later and LT4 was initiated 26 months after diagnosis. One in four patients with global developmental delay approached normal mental development after LT4 treatment. Four in six patients with short stature achieved height catch-up.ConclusionAt their initial HT diagnosis, most of the children showed hypothyroidism or subclinical hypothyroidism. Children with global developmental delay require continual screening, even if the thyroid function is normal after birth, to determine whether they have HT-induced hypothyroidism. Thyroxine replacement could partially relieve the clinical manifestations of hypothyroidism and early diagnosis and treatment are essential for improving patient prognosis.

scholarly journals Serum Fibroblast Growth Factor 21 Levels in Children and Adolescents with Hashimoto’s Thyroiditis before and after l-Thyroxin Medication: A Prospective Study

Medicina ◽  
2021 ◽  
Vol 57 (12) ◽  
pp. 1374
Author(s):  
Pavlos Drongitis ◽  
Eleni P. Kotanidou ◽  
Anastasios Serbis ◽  
Vasiliki Rengina Tsinopoulou ◽  
Spyridon Gerou ◽  
...  
Keyword(s):  
Growth Factor ◽  
Children And Adolescents ◽  
Fibroblast Growth Factor ◽  
Subclinical Hypothyroidism ◽  
Hashimoto’S Thyroiditis ◽  
Hashimoto's Thyroiditis ◽  
Fibroblast Growth Factor 21 ◽  
Control Group ◽  
Fibroblast Growth ◽  
Sites Of Action

Backgrounds and Objectives: Fibroblast growth factor 21 (FGF-21) is a complex hormone, sharing common sites of action with thyroid hormones. We investigated the association among FGF-21 levels, resting metabolic rate (RMR), and l-thyroxin (LT4) treatment in children and adolescents with Hashimoto’s thyroiditis. Materials and Methods: A total of 60 youngsters with chronic autoimmune thyroiditis (AIT) (30 with subclinical hypothyroidism, 30 with euthyroidism) and 30 age and sex-matched healthy participants (5–18 years old) were enrolled in the study. Anthropometric, biochemical parameters, and RMR levels were assessed in all participants; serum FGF-21 levels were measured in the control group and the group with subclinical hypothyroidism before and six months after medication with LT4. Results: FGF-21 levels were lower in the treatment group compared with the healthy ones, but this difference was not statistically significant (p > 0.05); despite the increase in FGF-21 levels after six months of LT4 treatment, this difference was not statistically significant (p > 0.05). Free thyroxin (FT4) levels correlated well with FGF-21 levels (r = 0.399, p < 0.01), but further analysis revealed no interaction between these two variables. Both patient groups presented elevated triglyceride (TG) levels compared to controls (p < 0.05). LT4 treatment had no impact on RMR and lipid or liver or glycaemic parameters. An increase in fat mass and fat-free mass were reported, independently of FGF-21 levels. Conclusions: In youngsters with subclinical hypothyroidism due to Hashimoto’s thyroiditis, the serum FGF-21 levels are not significantly lower than in healthy individuals and increase after treatment with LT4 without a statistical significance. Further studies with a large number of young patients and severe hypothyroidism are recommended to confirm our results.

scholarly journals Hashimoto's thyroiditis in children and adolescents

2008 ◽  
Vol 136 (5-6) ◽  
pp. 262-266 ◽  
Author(s):  
Slavica Markovic ◽  
Gordana Kostic ◽  
Zoran Igrutinovic ◽  
Biljana Vuletic
Keyword(s):  
Family History ◽  
Children And Adolescents ◽  
Thyroid Disease ◽  
Hashimoto’S Thyroiditis ◽  
Positive Family History ◽  
Clinical Manifestations ◽  
Hashimoto's Thyroiditis ◽  
Long Term Outcome ◽  
History Of

INTRODUCTION Hashimoto's thyroiditis (HT) is a common cause of goitre and hypothyroidism in children and adolescents. Spontaneous remission may occur in up to 50% patients, but the development of hypothyroidism is possible. OBJECTIVE We investigated the clinical manifestations, course and long-term outcome of HT. METHOD We reviewed charts of 43 children (36 females) with HT, mean age at presentation 12.3 years, and mean follow-up duration 4.6 years. RESULTS HT is five times more common in females. The common complaints leading to referral were goitre in 19 children (44.3%), diffuse in 17 children (89.5%). As to the prevalence of goitre, it accounted for significantly more referrals in females (14 girls, and 5 boys; 73.7% vs 26.3%, t-test; p<0.005). Goitre was either isolated in 15 (34.4%) or associated with other complaints in 4 children: anemia in 7 (16.2%), fatigue in 5 (11.8%), increased appetite in 4 (9.7%), weight gain in 3 (7.0%), growth retardation in 2 children (4.7%), at irregular menses in 3 pubertal girls. Hypothyroidism was present in 18 patients (41.1%), 7 (38.8%) on initial admission, and 11 (61.8%) had the mean follow-up duration of 4.6 years. There were 25 euthyroid HT patients (59.9%). The family history of the thyroid disease was positive in 16 children (37.1%) and 12 of them (71.4%) had hypothyroidism. There were 6 patients (13.9%) in whom the disease was associated with some other autoimmune disease. CONCLUSION HT is five times more common in females. The usual complaints leading to referral were diffuse goitre, which accounted for significantly more referrals in females. A positive family history of autoimmune thyroid disease is associated with a higher risk of hypothyroidism in children with HT. Hypothyroid patients may appear in higher percentage of children and adolescents than previously reported.

Clinical, biochemical, and radiological follow-up results of children and adolescents with Hashimoto’s thyroiditis: a single-center experience

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
İrem Ceren Erbaş ◽  
İbrahim Mert Erbaş ◽  
Olcay Evliyaoğlu
Keyword(s):  
Children And Adolescents ◽  
Adolescent Girls ◽  
Hashimoto’S Thyroiditis ◽  
Hashimoto's Thyroiditis ◽  
Papillary Thyroid ◽  
Single Center ◽  
Radiological Findings ◽  
Male Ratio ◽  
Single Center Experience

Abstract Objectives Hashimoto’s thyroiditis (HT) is the most common cause of goiter and acquired hypothyroidism in children and adolescents, especially in areas without endemic iodine deficiency. We aimed to evaluate the follow-up results of children and adolescents diagnosed with HT, including clinical, biochemical, and radiological findings and treatment approaches. Methods HT patients, who were diagnosed between 2012 and 2018 years in a single-center, were assessed retrospectively. Results Two hundred and twenty-four cases were included in the study, 75.9% of whom were girls (female/male ratio: 3.1) and 66.5% were pubertal. The median age of the cases at first admission was 12.5 (9.2–15) years. The median follow-up period of 196 patients, who continued their follow-up regularly, was 2.1 (0.7–4.8) years. When autoantibody levels were analyzed according to gender, mean anti-Tg levels were higher in girls (p=0.028), whereas anti-TPO levels were similar (p=0.372). A nodule was detected in the ultrasonographic follow-up of 29 (13%) patients. Papillary thyroid carcinoma was observed in 10.3% (n=3) of those with nodules. When the last ultrasonography findings of 188 patients with available radiological follow-up data were compared with their initial evaluation, the rate of heterogeneous parenchymal echogenicity increased significantly (p=0.008). The need for l-thyroxine dosage augmented over time. Conclusions Although HT is more common in adolescent girls, it can be encountered in both genders and at all ages in childhood. The incidence of malignancy was not higher in patients with nodules associated with HT than the reported incidences of malignancy in nodules not associated with HT.

Immune Thrombocytopenia in an Adolescent with Hashimoto’s Thyroiditis – Case Report

2019 ◽  
Vol 4 (3) ◽  
pp. 145-149 ◽  
Author(s):  
Izabella Kelemen ◽  
Zsuzsanna Erzsébet Papp ◽  
Mária Adrienne Horváth
Keyword(s):  
Platelet Count ◽  
Autoimmune Diseases ◽  
Hashimoto’S Thyroiditis ◽  
Clinical Signs ◽  
Immunoglobulin Therapy ◽  
Peripheral Blood Smear ◽  
Bleeding Complications ◽  
Hashimoto's Thyroiditis ◽  
Line Treatment ◽  
First Line

Abstract Introduction: In childhood, thrombocytopenia caused by transient antibody-mediated thrombocyte destruction is most frequently diagnosed as immune thrombocytopenic purpura (ITP). We report the case of a girl with ITP associated with autoimmune thyroiditis. Case presentation: A 11-year-old female patient with Hashimoto’s thyroiditis presented with clinical signs of petechiae and ecchymoses on the extremities. Laboratory tests showed remarkable thrombocytopenia with a platelet count of 44,500/μL, hence she was referred to a hematologic consultation. The peripheral blood smear showed normal size platelets in very low range. The bone marrow examination exposed hyperplasia of the megakaryocyte series with outwardly morphologic abnormalities. The patient was diagnosed with ITP, and her first-line treatment was pulsed steroid and immunoglobulin therapy. The thrombocytopenia was refractory to these first-line medications. After 6 months of corticotherapy and a period of severe menorrhagia, azathioprine immunosupression was initiated as a second-line treatment. Her platelet count rapidly increased, and the evolution was good, without bleeding complications. Conclusion: In case of a medical history of autoimmune diseases and treatment-resistant ITP, attention must be focused on detecting coexisting autoimmune diseases and adjusting the treatment in accordance with the chronic evolution of the disease.

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