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Evolution of Hashimoto thyroiditis in children with type 1 diabetes mellitus (TIDM)

Feneli Karachaliou1, Nikitas Skarakis1, Evangelia Bountouvi1

  • 1Unit of Pediatric Endocrinology and Diabetes, 3rd University Pediatric Clinic, Attikon University Hospital, Athens, Greece.

Journal of Pediatric Endocrinology & Metabolism : JPEM
|November 12, 2020
PubMed

Insights

Children with type 1 diabetes and Hashimoto thyroiditis show a higher risk of developing hypothyroidism. Early intervention may be beneficial for managing thyroid function in these pediatric patients.

Area of Science:

  • Pediatric Endocrinology
  • Autoimmune Diseases
  • Thyroidology

Background:

  • Hashimoto thyroiditis (HT) management in children, especially those with coexistent type 1 diabetes mellitus (T1DM), remains controversial, particularly with normal or mildly elevated TSH levels.
  • Understanding the natural progression of HT in children with T1DM is crucial for guiding treatment strategies.

Purpose of the Study:

  • To compare the natural course of HT in children with T1DM versus those without other autoimmune conditions.
  • To identify potential predictors of thyroid function deterioration in pediatric HT patients.

Main Methods:

  • Retrospective analysis of data from 96 children with HT, including 32 with T1DM and 64 without T1DM.
  • All participants had normal fT4 and TSH levels with at least three years of follow-up data.

Main Results:

  • Children with T1DM had a higher incidence of subclinical (34.4%) and overt hypothyroidism (6.2%) compared to those without T1DM (18.8% and 3.1%, respectively).
  • Overall, 40.6% of children with T1DM progressed to subclinical or overt hypothyroidism, versus 21.9% in the control group.

Conclusions:

  • The annual rate of conversion from euthyroidism to hypothyroidism is significantly higher in children with T1DM.
  • Further prospective randomized trials are recommended to evaluate the benefits of earlier therapeutic intervention for milder thyroid dysfunction in these children.
Abstract

Keywords:
Hashimoto thyroiditischildrentreatmenttype 1 diabetes

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