Thyroid function status at initial presentation in children with Hashimoto’s thyroiditis: A retrospective evaluation

INTRODUCTION: The objective of this study was to assess thyroid function status at the time of diagnosis in children with Hashimoto’s thyroiditis (HT) and to analyze the clinical and biochemical features of different presentations.
METHODS: Pediatric patients diagnosed with HT between January 2018 and December 2022 were retrospectively enrolled. At the initial evaluation, thyroid function status was used to categorize patients into five groups. Comparative analyses were performed to evaluate demographic, clinical, and laboratory characteristics among these categories.
RESULTS: Among the 270 patients included in the study (aged 2–18 years; mean age 12.1±3.5 years), 81.5% were female, 73.3% were pubertal, and 41.1% had a family history of thyroid disease. Most patients were identified through blood tests performed because of a positive family history or routine screening. Indications included annual screening for type 1 diabetes mellitus (5.9%), neck swelling (4.1%), constipation (1.9%), and vitiligo (1.5%). At diagnosis, 51.5% of patients were euthyroid, while 84 (31.1%) had subclinical hypothyroidism, 31 (11.5%) had overt hypothyroidism, 12 (4.4%) had subclinical hyperthyroidism, and 4 (1.5%) had overt hyperthyroidism.
DISCUSSION AND CONCLUSION: Most pediatric patients with HT in this study had normal or mildly affected thyroid hormone levels at diagnosis. A substantial proportion of patients were identified through a positive family history and routine screening for other autoimmune diseases, emphasizing the importance of antibody screening in children with a positive family history and in selected cases.

Keywords: Children, Hashimoto’s thyroiditis, thyroid function tests.