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Thyroid function test evolution in children with Hashimoto's thyroiditis is closely conditioned by the biochemical
Giuseppe Crisafulli1, Romina Gallizzi1, Tommaso Aversa1
1Department of Human Pathology in Adulthood and Childhood, University of Messina, Via Consolare Valeria, 98124, Messina, Italy.
Insights
Children with Hashimoto
Area of Science:
- Pediatric Endocrinology
- Immunology
Background:
- Hashimoto's thyroiditis (HT) is a common autoimmune disorder in children.
- Thyroid function patterns in pediatric HT vary significantly.
- Understanding these patterns is crucial for predicting disease progression.
Purpose of the Study:
- To review and synthesize current literature on the presentation and evolution of thyroid function in children with Hashimoto's thyroiditis.
- To identify risk factors and predict outcomes based on initial thyroid function status.
Main Methods:
- Literature review and synthesis of existing studies.
- Analysis of reported cases of pediatric Hashimoto's thyroiditis.
- Comparison of thyroid function evolution based on initial presentation (euthyroidism, subclinical hypothyroidism, hyperthyroidism).
Main Results:
- Children with HT and subclinical hypothyroidism (SH) have an increased risk of developing severe thyroid dysfunction over time compared to euthyroid children.
- Children with HT and overt or subclinical hyperthyroidism often experience resolution of the hyperthyroid phase within months, though with individual variability.
- The natural history of overt hypothyroidism in pediatric HT is not studied due to immediate treatment initiation.
Conclusions:
- Thyroid status may deteriorate over time, particularly in children with SH and euthyroid HT.
- Hyperthyroid phases in pediatric HT generally resolve definitively.
- Early identification of thyroid function status is key for managing pediatric Hashimoto's thyroiditis.
Abstract:
ᅟ: Aim of this commentary is to summarize the salient literature views on the relationships between presentation and evolution patterns of thyroid function in children with Hashimoto's thyroiditis (HT). According to the most recent reports, children with HT and subclinical hypothyroidism (SH) are more prone to the risk of developing severe thyroid dysfunctions over time, if compared to those presenting with euthyroidism. In contrast, children presenting with HT and either overt or subclinical hyperthyroidism are incline to exhibit a definitive resolution of the hyperthyroid phase within some months, although there is a wide variability between the different individuals. The natural history of frank hypothyroidism in the children with HT has never been investigated so far, since in these cases an immediate onset of replacement treatment is mandatory.
Conclusions:
1) a deterioration of thyroid status over time may be observed especially in the children presenting with SH, but also in those presenting with euthyroidism; 2) a definitive resolution of the hyperthyroid phase is generally observed in those presenting with either overt or subclinical hyperthyroidism.