Hashimoto’s disease in a cohort of 29 children and adolescents. Epidemiology, clinical course, and comorbidities in the short and long term

Abstract

Hashimoto's thyroiditis is the most common cause of goiter and hypothyroidism among children and adolescents. Its clinical manifestations and course vary. The objective of this study was to review the clinical and evolutionary characteristics of Hashimoto's disease in the pediatric population. Clinical, analytical, ultrasound, epidemiological, and evolutionary data of patients with autoimmune thyroiditis seen at Hospital Universitario San Juan de Alicante between January 2010 and January 2016 were analyzed. A total of 29 patients were included in the study. A higher prevalence of girls was observed, at a 2:1 ratio. The main reason for consultation was the accidental detection of high thyroid stimulating hormone levels or positive anti-thyroid antibodies in a lab test done for other reason. In the initial analysis, 53.3% of patients had subclinical hypothyroidism and only 10% of them had frank hypothyroidism. Two patients developed thyroid cancer. INTRODUCTIONHashimoto's thyroiditis is the most common cause of thyroid disease among children and adolescents. [1][2][3] The histological characteristics of this disease include the presence of a diffuse lymphocytic infiltrate in the thyroid gland accompanied by a variable degree of fibrosis.Its clinical manifestations at the time of diagnosis and clinical course vary. Most patients have no symptoms and a normal thyroid function at the time of diagnosis. Among symptomatic patients, the most common clinical manifestations are goiter and growth retardation. This disease is characterized by the presence of anti-thyroid peroxidase (TPO) antibodies and anti-thyroglobulin (TG) antibodies in blood. A thyroid hormone analysis and ultrasound are useful to make a complete diagnosis of these patients.The objective of this study was to review the clinical and evolutionary characteristics of Hashimoto's disease in a pediatric population. POPULATION AND METHODSHospital Universitario San Juan de Alicante sees patients from the Department of Health 17 of the Valencian Community and caters for a population of 220 000 inhabitants, with over 33 000 children and adolescents younger than 15 years.A descriptive, retrospective study was done in a cohort of patients diagnosed with autoimmune thyroiditis before 18 years old and seen at the Department of Pediatrics of Hospital Universitario San Juan de Alicante between January 2010 and January 2016.The study was approved by the hospital's Ethics Committee.The medical records of patients with final diagnosis of Hashimoto's thyroiditis or disease, autoimmune thyroiditis or hypothyroidism or chronic lymphocytic thyroiditis were included. presence of anti-thyroid antibodies; their followup included a complete physical examination and a thyroid function test every 6 months and labs, including complete autoimmunity testing, every year. An ultrasound was done initially and then twice-yearly. Different clinical, analytical, and ultrasound outcome measures were analyzed. The most important outcome measures included year and age at the time of d...

Perinatal risk factors for pediatric onset type 1 diabetes, autoimmune thyroiditis, juvenile idiopathic arthritis, and inflammatory bowel diseases

“…The prevalence of AIT in our study was 0.60%—over four times higher than in Scotland (1993–1995), with 0.135% for individuals under 22 years [ 22 ]. Furthermore, our incidence of pediatric AIT was 46.0—almost three times higher than in a Spanish study (2010–2016) with 16.7 in children under 15 years [ 23 ]. As for JIA, the incidence in our study was 55.0, higher than in previous decades (19.5 in 1995) [ 24 ].…”

The Role of Toll-like Receptor 2 (TLR2) in the Development and Progression of Hashimoto’s Disease (HD): A Case Study on Female Patients in Poland

“…According to literature reports, HD can affect up to 4.8–25.8% of women and 0.9–7.9% of men [ 3 , 4 , 5 ]. Studies show that the frequency of developing this disease increases with the age of patients (especially after 60 years of age); however, more and more often, this entity is also diagnosed in young people and even children [ 6 , 7 , 8 , 9 ]. The causes of hypothyroidism and thus the development of HD are many, ranging from genetic factors and hormonal changes to environmental factors, as well as the presence of other comorbidities, especially those of autoimmune origin [ 10 , 11 , 12 , 13 ].…”