Significant fluctuation of thyroid function in children with chronic lymphocytic thyroiditis

Area of Science:

• Pediatric Endocrinology
• Immunology
• Thyroidology

Background:

• Chronic lymphocytic thyroiditis (also known as Hashimoto's thyroiditis) is an autoimmune condition affecting the thyroid gland.
• Understanding pituitary reserve and thyroid function fluctuations is crucial for managing pediatric autoimmune thyroid diseases.

Purpose of the Study:

• To investigate the pituitary reserve of TSH secretion in children diagnosed with chronic lymphocytic thyroiditis.
• To analyze the dynamic changes and fluctuations in thyroid function over time in these patients.

Main Methods:

• Evaluated TSH response to TRH stimulation in 42 pediatric patients with chronic lymphocytic thyroiditis.
• Conducted retrospective follow-up of thyroid function in 2 patients and prospective follow-up in 4 patients.
• Monitored thyroid hormone levels (T4, T3) and TSH, alongside thyroid gland size.

Main Results:

• 16.8% of patients exhibited increased basal TSH levels.
• 35.8% showed an exaggerated TSH response to TRH loading, indicating altered pituitary reserve.
• Observed spontaneous recovery in some cases and transient hypothyroidism episodes lasting months, with concurrent changes in thyroid gland size.

Conclusions:

• Adolescents with chronic lymphocytic thyroiditis often present with exaggerated TSH secretion and decreased thyroid function.
• Thyroid function can exhibit significant fluctuations between euthyroid and hypothyroid states over short periods.
• The underlying causes of these functional changes, particularly transient hypothyroidism, require further investigation.