Underlying Hashimoto's Thyroiditis Negatively Affects the Evolution of Subclinical Hypothyroidism in Children Irrespective of Other Concomitant Risk Factors

Aversa, Tommaso; Valenzise, Mariella; Corrias, Andrea; Salerno, Mariacarolina; Luca, Filippo De; Mussa, Alessandro; Rezzuto, Martina; Lombardo, Fortunato; Wasniewska, Malgorzata

doi:10.1089/thy.2014.0235

Cited by 41 publications

(43 citation statements)

References 21 publications

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“…Furthermore, the results of the present study confirm, on the basis of a more prolonged prospective evaluation, the recent inference that underlying HT negatively affects the natural course of SH in children, irrespective of other concomitant risk factors (12). In fact, when compared with group A girls, those belonging to group B exhibited both decreased probabilities of TSH normalization and an increased risk of thyroid function deterioration over time, irrespectively of whether HT-related SH was or was not Another peculiar aspect of the present study is that the patient series with HT-related SH was in turn divided in three subcohorts of girls with or without chromosomopathies.…”

Section: Discussionsupporting

confidence: 90%

“…In the children with HT-related mild SH, it has been just recently reported that the evolution of thyroid function tests seems to be frequently characterized by a deterioration over time, whereas such risk is very low in the children with idiopathic SH (12). However, the available prospective studies on the natural history and prognosis of SH in children are very few and based on 2-3 years follow-up investigations (12,13,14,15,16), which hampers the ability of drawing firm conclusions about the relevance of those findings.…”

Section: Introductionmentioning

confidence: 99%

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Five-year prospective evaluation of thyroid function in girls with subclinical mild hypothyroidism of different etiology

Waśniewska

Aversa

Salerno

et al. 2015

European Journal of Endocrinology

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Aim: To follow-up for 5 years thyroid status evolution in 127 girls with mild (TSH 5-10 mU/l) subclinical hypothyroidism (SH) of different etiologies. Patients: The population was divided into two age-matched groups of 42 and 85 girls with either idiopathic (group A) or Hashimoto's thyroiditis (HT)-related SH (group B). Group B was in turn divided into three subgroups, according to whether SH was either isolated or associated with Turner syndrome (TS) or Down syndrome (DS). Results: At the end of follow-up the rate of girls who became euthyroid was higher in group A (61.9% vs 10.6%), whereas the rates of patients who remained SH (55.3% vs 26.2%), became overtly hypothyroid (30.6% vs 11.9%) or required levothyroxine (L-T 4 ) therapy (63.5% vs 23.8%) were higher in group B. Among the girls of group B, the risk of remaining SH or developing overt hypothyroidism was higher in the subgroups with TS or DS than in those with isolated HT. Conclusions: Long-term prognosis of mild and idiopathic SH is frequently benign, even though a L-T 4 treatment may be needed throughout follow-up in almost a quarter of cases; long-term prognosis is different in the girls with either idiopathic or HT-related SH; and the association with either TS or DS impairs the outcome of HT-related SH.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Five-year prospective evaluation of thyroid function in girls with subclinical mild hypothyroidism of different etiology

Waśniewska

Aversa

Salerno

et al. 2015

European Journal of Endocrinology

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“…A worsening of thyroid function was indeed observed after 3 years of follow-up among 21.4% of children with HT compared with 13.6% of patients with isolated hyperthyrotropinemia in a retrospective multicenter study [57]. These data were further confirmed in a 2-year prospective study that documented an increased risk of progression to overt hypothyroidism among children with mild SH associated with HT (53.1%) with respect to children with a mild nonautoimmune form (11.1%) [59]. …”

Section: Mild Hypothyroidism In Childrenmentioning

confidence: 79%

Mild Hypothyroidism in Childhood: Who, When, and How Should Be Treated?

Vigone

Capalbo

Weber

et al. 2018

Journal of the Endocrine Society

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Mild hypothyroidism, also known as subclinical hypothyroidism (SH), is biochemically defined as serum TSH levels above the upper limit of the reference range, in the presence of normal serum concentrations of total T4 and free T4 (FT4). In the neonatal period, mild hypothyroidism can be defined by the presence of a TSH value between 6 and 20 mIU/L and normal FT4 levels. After the neonatal period, SH can be defined mild if TSH ranges between 4.5 and 10 mIU/L. The management of mild hypothyroidism in childhood is challenging. The major concern is to establish whether this condition should always be considered an expression of mild thyroid dysfunction. Indeed, the effects of untreated mild hypothyroidism are still not completely defined. In the neonatal period, concern exists about neurocognitive outcome; in children, although there is no clear evidence of alterations in growth or neurocognitive development, subtle cardiovascular abnormalities have been documented. Therefore, there is still uncertainty about the need of treatment across all ages, and the management should be based on the age of the child, the etiology, and the degree of TSH elevation, as well as on other patient factors. This review updates current evidences on diagnosis and management of mild hypothyroidism in childhood.

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“…16 On the other hand, it is well known that SH may have a different outcome in idiopathic cases [21][22][23][24][25] and in those with an underlying HT. [26][27][28][29] It has clearly been shown that in children without HT or other thyroid diseases, DS may be associated with higher TSH levels, probably due to an inherent TSH setting disorder which seems to be peculiar to DS. 30 On the basis of such findings, these authors concluded that diagnosis of SH might be overestimated in DS and that L-T4 therapy in these patients should be contemplated only when TSH values are HT diagnosis due to the initial finding of a transient hyperthyroid biochemical picture, but at that time they had been negative.…”

Section: Resultsmentioning

confidence: 99%

Peculiarities of presentation and evolution over time of Hashimoto’s thyroiditis in children and adolescents with Down’s syndrome

Aversa¹,

Salerno²,

Radetti³

et al. 2015

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BACKGROUND: Studies concerning presentation and evolution over time of Hashimoto's thyroiditis (HT) in children with Down's syndrome (DS) are few, are based on limited study populations and do not include control HT groups without DS. The aim of this multicenter study was to shed further light on the relationships between DS and HT in childhood. DE-SIGN: In this retrospective study we compared thyroid function patterns at HT presentation in 2 groups of children with (group A) or without DS (group B), including 146 and 553 cases, respectively. All group A patients were subsequently re-examined after a median interval of 5.1 years in order to prospectively re-evaluate the evolution over time of thyroid function patterns in DS. RESULTS: In group A, female predominance, age at HT diagnosis and rates of familiarity for thyroid diseases were significantly lower than in group B, whilst the association with non-thyroidal autoimmune diseases was more frequent. The hormonal patterns that were most frequently found in the 2 groups were, respectively, subclinical hypothyroidism (in group A) and euthyroidism (in group B). Thyroid dysfunctions were, overall, more frequent in group A (86.3 vs 45.7%, p<0.001). At re-evaluation, DS children exhibited further deterioration of thyroid function with some cases switching towards Graves' disease (GD). CONCLUSIONS HT in DS children: a) presents earlier, is not associated with female predominance and is more frequently associated with other autoimmune diseases; b) presents only very infrequently with a euthyroid hormonal profile; c) in a limited rate of cases switches with time to GD.

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Underlying Hashimoto's Thyroiditis Negatively Affects the Evolution of Subclinical Hypothyroidism in Children Irrespective of Other Concomitant Risk Factors

Cited by 41 publications

References 21 publications

Five-year prospective evaluation of thyroid function in girls with subclinical mild hypothyroidism of different etiology

Five-year prospective evaluation of thyroid function in girls with subclinical mild hypothyroidism of different etiology

Mild Hypothyroidism in Childhood: Who, When, and How Should Be Treated?

Peculiarities of presentation and evolution over time of Hashimoto’s thyroiditis in children and adolescents with Down’s syndrome

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