Five-year prospective evaluation of thyroid function test evolution in children with Hashimoto's thyroiditis presenting with either euthyroidism or subclinical hypothyroidism.

Five-year prospective evaluation of thyroid function test evolution in children with Hashimoto's thyroiditis presenting with either euthyroidism or subclinical hypothyroidism.

Thyroid. 2016 Aug 19;

Authors: Aversa T, Corrias A, Salerno M, Tessaris D, Di Mase R, Valenzise M, Corica D, De Luca F, Wasniewska M

Abstract
BACKGROUND: Whether the course of thyroid function in Hashimoto's thyroiditis (HT) differs in children who present with either euthyroidism or subclinical hypothyroidism (SH) has been incompletely investigated.
AIM: To investigate, by means of a 5-year prospective evaluation of 234 children with HT and no prognostic risk factors, whether the evolution of the thyroid status is influenced by the biochemical pattern at initial diagnosis.
RESULTS: In the entire series, TSH values significantly increased during follow-up, whilst FT4 values decreased and the proportion of children with a thyroid dysfunction increased from 27.3 to 47.4% (p=0.0001). An increasing proportion of cases with severe thyroid dysfunction was identified, especially among the 64 patients presenting with SH (group B), but also among the 170 children presenting with euthyroidism (group A) at initial diagnosis. At the end of follow-up, the prevalence of children with overt hypothyroidism was 12.3% in group A vs 31.2% in group B (p=0.0007). In the overall population, however, the majority of patients (52.6%) exhibited, at the end of follow-up, biochemical euthyroidism.
CONCLUSIONS: a) children with HT may develop during the first 5 years of disease a deterioration of thyroid status; b) such a trend may be observed even in the patients who initially present with a mild biochemical picture (either SH or euthyroidism); c) 57.1% of initially euthyroid children remain euthyroid, and d) 40.6% of patients with initial SH normalize thyroid function within 5 years after HT diagnosis; e) the patients presenting with SH are more prone to the risk of developing severe thyroid dysfunction over time.

PMID: 27541075 [PubMed - as supplied by publisher]

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