Clinical Characteristic of Chronic Autoimmune Thyroiditis in Children

Chung, Hye Rim; Shin, Choong Ho; Yang, Sei Won

Abstract

PURPOSE
Although chronic autoimmune thyroiditis(AIT) is known to progress into overt hypothyroidism in adults, the outcomes of this disorder in pediatric patients are different from those in adults, so it is hard to predict its course. We reviewed clinical characteristics of chronic AIT in children.
METHODS
The medical records of 94 children, who were diagnosed as AIT, were analyzed, retrospectively. Of 58 patients, who had been followed up for more than three years, we investigated family history, age at diagnosis, initial thyroid function, initial level of thyroid peroxisome antibody and thyroglobulin antibody, and changes of thyroid function.
RESULTS
Ninety four patients were all females and mean age at diagnosis was 11.2+/-2.3 years. Twenty five patients had family histories of thyroid disease. None of them had an other autoimmune endocrine disease. At diagnosis, 51 patients were hypothyroid, and 43 patients were euthyroid. Of 58 patients, who had been followed up for more than three years, 35 patients were hypothyroid and 23 patients were euthyroid at diagnosis. At last follow-up, 22 patients were hypothyroid, 33 patients were euthyroid, and three patients were hyperthyroid. The patients of hypothyroidism at last follow-up revealed significantly higher TSH levels at initial diagnosis, although initial TSH levels fell into a normal range, compared with patients of euthyroidism at last follow up.
CONCLUSION
The clinical course of AIT in children was variable. Particularly we should monitor thyroid function closely in patients who revealed higher TSH levels at the initial diagnosis, even if these are within normal limits, because they are prone to develop hypothyroidism during follow up.