Clinical features in children and adolescents with Hashimoto’s thyroiditis

INTRODUCTION: Hashimoto’s thyroiditis (chronic autoimmune thyroiditis) is the most common cause of goiter and acquired hypothyroidism among children and adolescents. It is an autoimmune disease intrinsic to thyroid tissue. In our study, we aim to review the files of children and adolescents with Hashimoto’s thyroiditis, being followed up in the Department of Pediatric Endocrinology, and to compare these results with findings in the literature.
METHODS: In the study, the files of 114 children and adolescents with Hashimoto’s thyroiditis, being followed up in Zeynep Kamil Maternity and Children’s Diseases Health Training and Research Center, Pediatric Endocrinology Department, were reviewed retrospectively. Patients were grouped by age at diagnosis and the clinical parameters were compared between the groups.
RESULTS: There were 102 females (89.5%) and 12 males (10.5%), with a female/male ratio of 8.5/1. The average age of the patients at diagnosis was 11.91±3.26 years. 77 (67.5%) patients have a positive family history. 14 (12.28%) patients have a concomitant autoimmune disease. On the first admission to the hospital, 47 (41.2%) patients were euthyroid, 46 (40.4%) patients were subclinical hypothyroid, 10 (8.8%) patients were overt hypothyroid, 3 (2.6%) patients were subclinical hyperthyroid, and 8 (7.0%) patients were overt hyperthyroid. Antithyroid peroxidase antibodies were positive in 109 (95.6%) and antithyroglobulin antibodies were positive in 105 (92.1%) of the patients. In the group under 12 years old, there were 7 (13.2%) patients with radiation exposure, whereas in the group over 12 years old, there was only 1 (1.9%) patient with radiation exposure, and thus the difference between the two groups was statistically meaningful.
DISCUSSION AND CONCLUSION: Patients who have clinical and laboratory evidence of thyroid disease should be examined for autoimmune thyroiditis. Especially, it is very important that patients who have clinical evidence of other autoimmune diseases, have a family history of autoimmune thyroiditis, and/or a history of radiation exposure should be examined periodically and followed up closely.