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Published in: Italian Journal of Pediatrics 1/2013

Open Access 01-12-2013 | Commentary

Hashimoto's thyroiditis in childhood: presentation modes and evolution over time

Authors: Filippo De Luca, Simona Santucci, Domenico Corica, Elda Pitrolo, Marika Romeo, Tommaso Aversa

Published in: Italian Journal of Pediatrics | Issue 1/2013

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Abstract

Aim of this survey is to report the most recent views about Hashimoto’s thyroiditis (HT) natural history according to the different presentations. In children presenting with either euthyroidism or subclinical hypothyroidism HT spontaneous course is frequently characterized by a trend towards deterioration of thyroid function, whereas in those presenting with overt hyperthyroidism a definitive resolution of hyperthyroid phase is to be expected. Another possible even though unusual outcome of HT is the conversion to Graves’ disease.
Literature
1.
go back to reference Ilicki A, Marcus C, Karlsson FA: Hyperthyroidism and hypothyroidism in monozygotic twins: detection of stimulating and blocking THS receptor antibodies using the FRTL5-cell line. J Endocrinol Invest. 1990, 13: 327-331.CrossRefPubMed Ilicki A, Marcus C, Karlsson FA: Hyperthyroidism and hypothyroidism in monozygotic twins: detection of stimulating and blocking THS receptor antibodies using the FRTL5-cell line. J Endocrinol Invest. 1990, 13: 327-331.CrossRefPubMed
2.
go back to reference Tani J, Yoshida K, Fukazawa H, Kiso Y, Sayama N, Mori K, Alzawa Y, Hori H, Nakasato N, Abe K: Hyperthyroid Graves' disease and primary hypothyroidism caused by TSH receptor antibodies in monozygotic twins: case reports. Endocr J. 1998, 45: 117-121. 10.1507/endocrj.45.117.CrossRefPubMed Tani J, Yoshida K, Fukazawa H, Kiso Y, Sayama N, Mori K, Alzawa Y, Hori H, Nakasato N, Abe K: Hyperthyroid Graves' disease and primary hypothyroidism caused by TSH receptor antibodies in monozygotic twins: case reports. Endocr J. 1998, 45: 117-121. 10.1507/endocrj.45.117.CrossRefPubMed
3.
go back to reference Aust G, Krohn K, Morgenthaler NG, Schröder S, Edelmann J, Brylla E: Graves' disease and Hashimoto's thyroiditis in monozygotic twins: case study as well as transcriptomic and immunohistological analysis of thyroid tissues. Eur J Endocrinol. 2006, 154: 13-20. 10.1530/eje.1.02063.CrossRefPubMed Aust G, Krohn K, Morgenthaler NG, Schröder S, Edelmann J, Brylla E: Graves' disease and Hashimoto's thyroiditis in monozygotic twins: case study as well as transcriptomic and immunohistological analysis of thyroid tissues. Eur J Endocrinol. 2006, 154: 13-20. 10.1530/eje.1.02063.CrossRefPubMed
4.
go back to reference Desai MP, Karandikar S: Autoimmune thyroid disease in childhood: a study of children and their families. Indian Pediatr. 1999, 36: 659-668.PubMed Desai MP, Karandikar S: Autoimmune thyroid disease in childhood: a study of children and their families. Indian Pediatr. 1999, 36: 659-668.PubMed
5.
go back to reference Doniach D: Humoral and genetic aspects of thyroid autoimmunity. Clin Endocrinol Metab. 1975, 4: 267-285. 10.1016/S0300-595X(75)80022-3.CrossRef Doniach D: Humoral and genetic aspects of thyroid autoimmunity. Clin Endocrinol Metab. 1975, 4: 267-285. 10.1016/S0300-595X(75)80022-3.CrossRef
6.
go back to reference Wood LC, Ingbar SH: Hypothyroidism as a late sequela in patient with Graves' disease treated with antithyroid agents. J Clin Invest. 1979, 64: 1429-1436. 10.1172/JCI109601.PubMedCentralCrossRefPubMed Wood LC, Ingbar SH: Hypothyroidism as a late sequela in patient with Graves' disease treated with antithyroid agents. J Clin Invest. 1979, 64: 1429-1436. 10.1172/JCI109601.PubMedCentralCrossRefPubMed
7.
go back to reference le Berre JP, Rousseau C, Dupuy O, Bordier L, Mayaudon H, Bauduceau B: Unusual evolution of autoimmune hypothyroidism: occurrence of Grave's disease. (in French). Rev Med Interne. 2004, 25: 841-843.CrossRefPubMed le Berre JP, Rousseau C, Dupuy O, Bordier L, Mayaudon H, Bauduceau B: Unusual evolution of autoimmune hypothyroidism: occurrence of Grave's disease. (in French). Rev Med Interne. 2004, 25: 841-843.CrossRefPubMed
8.
go back to reference Ludgate M, Emerson CH: Metamorphic thyroid autoimmunity. Thyroid. 2008, 18: 1035-1037. 10.1089/thy.2008.1551.CrossRefPubMed Ludgate M, Emerson CH: Metamorphic thyroid autoimmunity. Thyroid. 2008, 18: 1035-1037. 10.1089/thy.2008.1551.CrossRefPubMed
9.
go back to reference Wasniewska M, Corrias A, Arrigo T, Lombardo F, Salerno M, Mussa A, Vigone MC, De Luca F: Frequency of Hashimoto's thyroiditis antecedents in the history of children and adolescents with graves' disease. Horm Res Paediatr. 2010, 73: 473-476. 10.1159/000313395.CrossRefPubMed Wasniewska M, Corrias A, Arrigo T, Lombardo F, Salerno M, Mussa A, Vigone MC, De Luca F: Frequency of Hashimoto's thyroiditis antecedents in the history of children and adolescents with graves' disease. Horm Res Paediatr. 2010, 73: 473-476. 10.1159/000313395.CrossRefPubMed
10.
go back to reference Wasniewska M, Vigone MC, Cappa M, Aversa T, Rubino M, De Luca F: Study Group for Thyroid diseases of Italian Society for Pediatric Endocrinology: Acute suppurative thyroiditis in childhood: relative frequency among thyroid inflammatory diseases. J Endocrinol Invest. 2007, 30: 346-347.CrossRefPubMed Wasniewska M, Vigone MC, Cappa M, Aversa T, Rubino M, De Luca F: Study Group for Thyroid diseases of Italian Society for Pediatric Endocrinology: Acute suppurative thyroiditis in childhood: relative frequency among thyroid inflammatory diseases. J Endocrinol Invest. 2007, 30: 346-347.CrossRefPubMed
11.
go back to reference de Vries L, Bulvik S, Phillip M: Chronic autoimmune thyroiditis in children and adolescents: at presentation and during long-term follow-up. Arch Dis Child. 2009, 94: 33-37. 10.1136/adc.2007.134841.CrossRefPubMed de Vries L, Bulvik S, Phillip M: Chronic autoimmune thyroiditis in children and adolescents: at presentation and during long-term follow-up. Arch Dis Child. 2009, 94: 33-37. 10.1136/adc.2007.134841.CrossRefPubMed
12.
go back to reference Zak T, Noczyńska A, Wasikowa R, Zaleska-Dorobisz U, Golenko A: Chronic autoimmune thyroid disease in children and adolescents in the years 1999-2004 in Lower Silesia. Poland. Hormones. 2005, 4: 45-48.CrossRefPubMed Zak T, Noczyńska A, Wasikowa R, Zaleska-Dorobisz U, Golenko A: Chronic autoimmune thyroid disease in children and adolescents in the years 1999-2004 in Lower Silesia. Poland. Hormones. 2005, 4: 45-48.CrossRefPubMed
13.
go back to reference Gopalakrishnan S, Chugh PK, Chhillar M, Ambardar VK, Sahoo M, Sankar R: Goitrous autoimmune thyroiditis in a pediatric population: a longitudinal study. Pediatrics. 2008, 122: e670-e674. 10.1542/peds.2008-0493.CrossRefPubMed Gopalakrishnan S, Chugh PK, Chhillar M, Ambardar VK, Sahoo M, Sankar R: Goitrous autoimmune thyroiditis in a pediatric population: a longitudinal study. Pediatrics. 2008, 122: e670-e674. 10.1542/peds.2008-0493.CrossRefPubMed
14.
go back to reference Demirbilek H, Kandemir N, Gonc EN, Ozon A, Alikasifoglu A: Assessment of thyroid function during the long course of Hashimoto's thyroiditis in children and adolescents. Clin Endocrinol. 2009, 71: 451-454. 10.1111/j.1365-2265.2008.03501.x.CrossRef Demirbilek H, Kandemir N, Gonc EN, Ozon A, Alikasifoglu A: Assessment of thyroid function during the long course of Hashimoto's thyroiditis in children and adolescents. Clin Endocrinol. 2009, 71: 451-454. 10.1111/j.1365-2265.2008.03501.x.CrossRef
15.
go back to reference Skarpa V, Kappaousta E, Tertipi A, Anyfandakis K, Vakaki M, Dolianiti M, Fotinou A, Papathanasiou A: Epidemiological characteristics of children with autoimmune thyroid disease. Hormones. 2011, 10: 207-214.CrossRefPubMed Skarpa V, Kappaousta E, Tertipi A, Anyfandakis K, Vakaki M, Dolianiti M, Fotinou A, Papathanasiou A: Epidemiological characteristics of children with autoimmune thyroid disease. Hormones. 2011, 10: 207-214.CrossRefPubMed
16.
go back to reference Özen S, Berk Ö, Şimşek DG, Darcan S: Clinical course of Hashimoto's thyroiditis and effects of levothyroxine therapy on the clinical course of the disease in children and adolescents. J Clin Res Pediatr Endocrinol. 2011, 3: 192-197. 10.4274/jcrpe.425.PubMedCentralCrossRefPubMed Özen S, Berk Ö, Şimşek DG, Darcan S: Clinical course of Hashimoto's thyroiditis and effects of levothyroxine therapy on the clinical course of the disease in children and adolescents. J Clin Res Pediatr Endocrinol. 2011, 3: 192-197. 10.4274/jcrpe.425.PubMedCentralCrossRefPubMed
17.
go back to reference Wasniewska M, Corrias A, Salerno M, Mussa A, Capalbo D, Messina MF, Aversa T, Bombaci S, De Luca F, Valenzise M: Thyroid Function Patterns at Hashimoto's Thyroiditis Presentation in Childhood and Adolescence Are Mainly Conditioned by Patients' Age. Horm Res Paediatr. 2012, 78: 232-236. 10.1159/000343815.CrossRefPubMed Wasniewska M, Corrias A, Salerno M, Mussa A, Capalbo D, Messina MF, Aversa T, Bombaci S, De Luca F, Valenzise M: Thyroid Function Patterns at Hashimoto's Thyroiditis Presentation in Childhood and Adolescence Are Mainly Conditioned by Patients' Age. Horm Res Paediatr. 2012, 78: 232-236. 10.1159/000343815.CrossRefPubMed
18.
go back to reference Corrias A, Cassio A, Weber G, Mussa A, Wasniewska M, Rapa A, Gastaldi R, Einaudi S, Baronio F, Vigone MC, Messina MF, Bal M, Bona G, De Sanctis C: Study group for thyroid diseases of Italian society for pediatric endocrinology and diabetology (SIEDP/ISPED): thyroid nodules and cancer in children and adolescents affected by autoimmune thyroiditis. Arch Pediatr Adolesc Med. 2008, 162: 526-531. 10.1001/archpedi.162.6.526.CrossRefPubMed Corrias A, Cassio A, Weber G, Mussa A, Wasniewska M, Rapa A, Gastaldi R, Einaudi S, Baronio F, Vigone MC, Messina MF, Bal M, Bona G, De Sanctis C: Study group for thyroid diseases of Italian society for pediatric endocrinology and diabetology (SIEDP/ISPED): thyroid nodules and cancer in children and adolescents affected by autoimmune thyroiditis. Arch Pediatr Adolesc Med. 2008, 162: 526-531. 10.1001/archpedi.162.6.526.CrossRefPubMed
19.
go back to reference Rallison ML, Dobyns BM, Keating FR, Rall JE, Tyler FH: Occurrence and natural history of chronic lymphocytic thyroiditis in childhood. J Pediatr. 1975, 86: 675-82. 10.1016/S0022-3476(75)80350-7.CrossRefPubMed Rallison ML, Dobyns BM, Keating FR, Rall JE, Tyler FH: Occurrence and natural history of chronic lymphocytic thyroiditis in childhood. J Pediatr. 1975, 86: 675-82. 10.1016/S0022-3476(75)80350-7.CrossRefPubMed
20.
go back to reference Williamson S, Greene SA: Incidence of thyrotoxicosis in childhood: a national population based study in the UK and Ireland. Clin Endocrinol. 2010, 72: 358-363. 10.1111/j.1365-2265.2009.03717.x.CrossRef Williamson S, Greene SA: Incidence of thyrotoxicosis in childhood: a national population based study in the UK and Ireland. Clin Endocrinol. 2010, 72: 358-363. 10.1111/j.1365-2265.2009.03717.x.CrossRef
21.
go back to reference Nabhan ZM, Kreher NC, Eugster EA: Hashitoxicosis in children: clinical features and natural history. J Pediatr. 2005, 146: 533-536. 10.1016/j.jpeds.2004.10.070.CrossRefPubMed Nabhan ZM, Kreher NC, Eugster EA: Hashitoxicosis in children: clinical features and natural history. J Pediatr. 2005, 146: 533-536. 10.1016/j.jpeds.2004.10.070.CrossRefPubMed
22.
go back to reference Reinwein D, Benker G, König MP, Pinchera A, Schatz H, Schleusener A: The different types of hyperthyroidism in Europe. Results of a prospective survey of 924 patients. J Endocrinol Invest. 1988, 11: 193-200.CrossRefPubMed Reinwein D, Benker G, König MP, Pinchera A, Schatz H, Schleusener A: The different types of hyperthyroidism in Europe. Results of a prospective survey of 924 patients. J Endocrinol Invest. 1988, 11: 193-200.CrossRefPubMed
23.
go back to reference Wasniewska M, Corrias A, Salerno M, Lombardo F, Aversa T, Mussa A, Capalbo D, De Luca F, Valenzise M: Outcomes of children with hashitoxicosis. Horm Res Paediatr. 2012, 77: 36-40. 10.1159/000334640.CrossRefPubMed Wasniewska M, Corrias A, Salerno M, Lombardo F, Aversa T, Mussa A, Capalbo D, De Luca F, Valenzise M: Outcomes of children with hashitoxicosis. Horm Res Paediatr. 2012, 77: 36-40. 10.1159/000334640.CrossRefPubMed
24.
go back to reference Radetti G, Gottardi E, Bona G, Corrias A, Salardi S, Loche S: Study group for thyroid diseases of the Italian society for pediatric endocrinology and diabetes (SIEDP/ISPED): the natural history of euthyroid Hashimoto's thyroiditis in children. J Pediatr. 2006, 149: 827-832. 10.1016/j.jpeds.2006.08.045.CrossRefPubMed Radetti G, Gottardi E, Bona G, Corrias A, Salardi S, Loche S: Study group for thyroid diseases of the Italian society for pediatric endocrinology and diabetes (SIEDP/ISPED): the natural history of euthyroid Hashimoto's thyroiditis in children. J Pediatr. 2006, 149: 827-832. 10.1016/j.jpeds.2006.08.045.CrossRefPubMed
25.
go back to reference Radetti G, Maselli M, Buzit F, Corrias A, Mussa A, Cambiaso P, Salerno M, Cappa M, Baiocchi M, Gastaldi R, Minerba L, Loche S: The natural history of the normal/mild elevated TSH serum levels in children and adolescents with Hashimoto's thyroiditis and isolated hyperthyrotropinaemia: a 3-year follow-up. Clin Endocrinol. 2012, 76: 394-398. 10.1111/j.1365-2265.2011.04251.x.CrossRef Radetti G, Maselli M, Buzit F, Corrias A, Mussa A, Cambiaso P, Salerno M, Cappa M, Baiocchi M, Gastaldi R, Minerba L, Loche S: The natural history of the normal/mild elevated TSH serum levels in children and adolescents with Hashimoto's thyroiditis and isolated hyperthyrotropinaemia: a 3-year follow-up. Clin Endocrinol. 2012, 76: 394-398. 10.1111/j.1365-2265.2011.04251.x.CrossRef
26.
go back to reference Wasniewska M, Corrias A, Aversa T, Valenzise M, Mussa A, De Martino L, Lombardo F, De Luca F, Salerno M: Comparative evaluation of therapy with L-thyroxine versus no treatment in children with idiopathic and mild subclinical hypothyroidism. Horm Res Paediatr. 2012, 77: 376-381. 10.1159/000339156.CrossRefPubMed Wasniewska M, Corrias A, Aversa T, Valenzise M, Mussa A, De Martino L, Lombardo F, De Luca F, Salerno M: Comparative evaluation of therapy with L-thyroxine versus no treatment in children with idiopathic and mild subclinical hypothyroidism. Horm Res Paediatr. 2012, 77: 376-381. 10.1159/000339156.CrossRefPubMed
27.
go back to reference Díez JJ, Iglesias P, Burman KD: Spontaneous normalization of thyrotropin concentrations in patients with subclinical hypothyroidism. J Clin Endocrinol Metab. 2005, 90: 4124-4127. 10.1210/jc.2005-0375.CrossRefPubMed Díez JJ, Iglesias P, Burman KD: Spontaneous normalization of thyrotropin concentrations in patients with subclinical hypothyroidism. J Clin Endocrinol Metab. 2005, 90: 4124-4127. 10.1210/jc.2005-0375.CrossRefPubMed
28.
go back to reference Wasniewska M, Salerno M, Cassio A, Corrias A, Aversa T, Zirilli G, Capalbo D, Bal M, Mussa A, De Luca F: Prospective evaluation of the natural course of idiopathic subclinical hypothyroidism in childhood and adolescence. Eur J Endocrinol. 2009, 160: 417-421.CrossRefPubMed Wasniewska M, Salerno M, Cassio A, Corrias A, Aversa T, Zirilli G, Capalbo D, Bal M, Mussa A, De Luca F: Prospective evaluation of the natural course of idiopathic subclinical hypothyroidism in childhood and adolescence. Eur J Endocrinol. 2009, 160: 417-421.CrossRefPubMed
29.
go back to reference Cerbone M, Bravaccio C, Capalbo D, Polizzi M, Wasniewska M, Cioffi D, Improda N, Valenzise M, Bruzzese D, De Luca F, Salerno M: Linear growth and intellectual outcome in children with long-term idiopathic subclinical hypothyroidism. Eur J Endocrinol. 2011, 164: 591-597. 10.1530/EJE-10-0979.CrossRefPubMed Cerbone M, Bravaccio C, Capalbo D, Polizzi M, Wasniewska M, Cioffi D, Improda N, Valenzise M, Bruzzese D, De Luca F, Salerno M: Linear growth and intellectual outcome in children with long-term idiopathic subclinical hypothyroidism. Eur J Endocrinol. 2011, 164: 591-597. 10.1530/EJE-10-0979.CrossRefPubMed
30.
go back to reference Arrigo T, Wasniewska M, Crisafulli G, Lombardo F, Messina MF, Rulli I, Salzano G, Valenzise M, Zirilli G, De Luca F: Subclinical hypothyroidism: the state of the art. J Endocrinol Invest. 2008, 31: 79-84.CrossRefPubMed Arrigo T, Wasniewska M, Crisafulli G, Lombardo F, Messina MF, Rulli I, Salzano G, Valenzise M, Zirilli G, De Luca F: Subclinical hypothyroidism: the state of the art. J Endocrinol Invest. 2008, 31: 79-84.CrossRefPubMed
31.
go back to reference De Luca F, Wasniewska M, Zirilli G, Aversa T, Arrigo T: At the end of a two-year follow-up elevated TSH levels normalize or remain unchanged in most the children with subclinical hypothyroidism. Ital J Pediatr. 2010, 36: 11-10.1186/1824-7288-36-11.PubMedCentralCrossRefPubMed De Luca F, Wasniewska M, Zirilli G, Aversa T, Arrigo T: At the end of a two-year follow-up elevated TSH levels normalize or remain unchanged in most the children with subclinical hypothyroidism. Ital J Pediatr. 2010, 36: 11-10.1186/1824-7288-36-11.PubMedCentralCrossRefPubMed
32.
go back to reference Monzani A, Prodam F, Rapa A, Moia S, Agarla V, Bellone S, Bona G: Natural history of subclinical hypothyroidism in children and adolescents and potential effects of replacement therapy: a review. Eur J Endocrinol. 2012, 168: R1-R11. 10.1530/EJE-12-0656.CrossRefPubMed Monzani A, Prodam F, Rapa A, Moia S, Agarla V, Bellone S, Bona G: Natural history of subclinical hypothyroidism in children and adolescents and potential effects of replacement therapy: a review. Eur J Endocrinol. 2012, 168: R1-R11. 10.1530/EJE-12-0656.CrossRefPubMed
33.
go back to reference Bona G, Prodam F, Monzani A: Subclinical hypothyroidism in children: natural history and when to treat. J Clin Res Pediatr Endocrinol. 2012, 10.4274/jcrpe.851. Nov 15 [Epub ahead of print] Bona G, Prodam F, Monzani A: Subclinical hypothyroidism in children: natural history and when to treat. J Clin Res Pediatr Endocrinol. 2012, 10.4274/jcrpe.851. Nov 15 [Epub ahead of print]
34.
go back to reference Ohye H, Nishihara E, Sasaki I, Kubota S, Fukata S, Amino N, Kuma K, Miyauchi A: Four cases of Graves' disease which developed after painful Hashimoto's thyroiditis. Intern Med. 2006, 45: 385-389. 10.2169/internalmedicine.45.1506.CrossRefPubMed Ohye H, Nishihara E, Sasaki I, Kubota S, Fukata S, Amino N, Kuma K, Miyauchi A: Four cases of Graves' disease which developed after painful Hashimoto's thyroiditis. Intern Med. 2006, 45: 385-389. 10.2169/internalmedicine.45.1506.CrossRefPubMed
35.
go back to reference Champion B, Gopinath B, Ma G, El-Kaissi S, Wall JR: Conversion to Graves' hyperthyroidism in a patient with hypothyroidism due to Hashimoto's thyroiditis documented by real-time thyroid ultrasonography. Thyroid. 2008, 18: 1135-1137. 10.1089/thy.2008.0142.CrossRefPubMed Champion B, Gopinath B, Ma G, El-Kaissi S, Wall JR: Conversion to Graves' hyperthyroidism in a patient with hypothyroidism due to Hashimoto's thyroiditis documented by real-time thyroid ultrasonography. Thyroid. 2008, 18: 1135-1137. 10.1089/thy.2008.0142.CrossRefPubMed
Metadata
Title
Hashimoto's thyroiditis in childhood: presentation modes and evolution over time
Authors
Filippo De Luca
Simona Santucci
Domenico Corica
Elda Pitrolo
Marika Romeo
Tommaso Aversa
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Italian Journal of Pediatrics / Issue 1/2013
Electronic ISSN: 1824-7288
DOI
https://doi.org/10.1186/1824-7288-39-8

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