Clinical Follow-Up of Children and Adolescents with Hashimoto Thyroiditis

Hwang, A Rum; Lee, Jung Eun; Cho, Won Kyoung; Park, So Hyun; Hahn, Seung Hoon; Jung, Min Ho; Suh, Byung Kyu

Abstract

PURPOSE: We aimed to study the clinical manifestations and clinical course of Hashimoto thyroiditis in children and adolescents.
METHODS
We retrospectively analyzed the clinical manifestations and thyroid function in 59 children and adolescents with Hashimoto thyroiditis who were admitted at Kangnam St. Mary's Hospital between January 1999 and January 2009.
RESULTS
We investigated thyroid function and clinical manifestations of thyroiditis in 50 female and 9 male patients. The mean age of the patients at the time of diagnosis was 10.6+/-2.7 years, and the mean duration of follow-up was 3.8+/-3.1 years. The most common complaints at the time of diagnosis were goiter (77.9%), fatigue (38.9%), weight gain, constipation, growth retardation, headache, nervousness, cold intolerance, and menstrual disturbances. Antithyroid peroxidase antibodies were detected in 52 patients (88.1%); antithyroglobulin antibodies, 45 patients (76.2%); and both antibodies, 42 patients (71.1%). The height, weight, and body mass index (BMI) standard deviation scores (SDS) of the patients at the time of diagnosis were not markedly different from the corresponding scores at the patients' last visit. At the time of the last follow-up, 19 patients were in remission and 40 were in non-remission state. At the first visit, there were no significant differences between the age, thyroid function test, positive rate of thyroid autoantibody, weight, and BMI SDS of patients in the remission group (RG) and non- remission group (N-RG). However, at the time of initial diagnosis, the height (Ht)-SDS of the patients in RG were greater than in N-RG (P=0.037). At the end of follow up, euthyroidism was achieved in 53 patients, 5 patients had compensated hypothyroidism, and 1 patient had overt hypothyroidism.
CONCLUSION
The patients with thyroid dysfunction at diagnosis were 72.9% and 32.2% of patients were in remission. We could not find out significant predictive factor for remission at the time of diagnosis and further studies with a large number of subjects should be performed.