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Italian Journal of Pediatrics
Published in: Italian Journal of Pediatrics 1/2018

Open Access 01-12-2018 | Commentary

Thyroid function test evolution in children with Hashimoto’s thyroiditis is closely conditioned by the biochemical picture at diagnosis

Authors: Giuseppe Crisafulli, Romina Gallizzi, Tommaso Aversa, Giuseppina Salzano, Mariella Valenzise, Malgorzata Wasniewska, Filippo De Luca, Giuseppina Zirilli

Published in: Italian Journal of Pediatrics | Issue 1/2018

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Abstract

ᅟ

Aim of this commentary is to summarize the salient literature views on the relationships between presentation and evolution patterns of thyroid function in children with Hashimoto’s thyroiditis (HT).
According to the most recent reports, children with HT and subclinical hypothyroidism (SH) are more prone to the risk of developing severe thyroid dysfunctions over time, if compared to those presenting with euthyroidism.
In contrast, children presenting with HT and either overt or subclinical hyperthyroidism are incline to exhibit a definitive resolution of the hyperthyroid phase within some months, although there is a wide variability between the different individuals.
The natural history of frank hypothyroidism in the children with HT has never been investigated so far, since in these cases an immediate onset of replacement treatment is mandatory.

Conclusions

1) a deterioration of thyroid status over time may be observed especially in the children presenting with SH, but also in those presenting with euthyroidism; 2) a definitive resolution of the hyperthyroid phase is generally observed in those presenting with either overt or subclinical hyperthyroidism.
Literature
1.
Akamizu T, Amino N, DeGroot LJ. Hashimoto’s Thyroiditis. In: De Groot LJ, Beck-Peccoz P, Chrousos G, Dungan K, Grossman A, Hershman JM, Koch C, McLachlan R, New M, Rebar R, Singer F, Vinik A, Weickert MO, editors. . South Dartmouth: MDText.com, Inc.; 2013. 2000-. 2013 Dec 20.
2.
Wasniewska M, Vigone MC, Cappa M, Aversa T, Rubino M, De Luca F. Acute suppurative thyroiditis in childhood: relative frequency among thyroid inflammatory diseases. J Endocrinol Investig. 2007;30:346–7.CrossRef
3.
Kabelitz M, Liesenkötter KP, Stach B, Willgerodt H, Stäblein W, Singendonk W, et al. The prevalence of anti-thyroid peroxidase antibodies and autoimmune thyroiditis in children and adolescents in an iodine replete area. Eur J Endocrinol. 2003;148:301–7.CrossRefPubMed
4.
Wasniewska M, Corrias A, Salerno M, Mussa A, Capalbo D, Messina MF, et al. Thyroid function patterns at Hashimoto's thyroiditis presentation in childhood and adolescence are mainly conditioned by patients’ age. Horm Res Paediatr. 2012;78:232–6.CrossRefPubMed
5.
De Luca F, Santucci S, Corica D, Pitrolo E, Romeo M, Aversa T. Hashimoto’s thyroiditis in childhood: presentation modes and evolution over time. Ital J Pediatr. 2013;30:39–48.
6.
De Luca F, Aversa T, Salzano G, Zirilli G, Sferlazzas C, Wasniewska M. Autoimmune thyroiditis. In: Bona G, De Luca F, Monzani A, editors. Thyroid diseases in childhood: Recent advances from basic science to clinical practice. Switzerland: Springer International publishing; 2015. p. 181–94.CrossRef
7.
Wasniewska M, Corrias A, Arrigo T, Lombardo F, Salerno M, Mussa A, et al. Frequency of Hashimoto’s thyroiditis antecedents in the history of children and adolescents with graves’ disease. Horm Res Paediatr. 2010;73:473–6.CrossRefPubMed
8.
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;18:1135–7.CrossRefPubMed
9.
10.
Troisi A, Novati P, Sali L, Colzani M, Monti G, Cardillo C, et al. Graves’ thyrotoxicosis following Hashimoto’s thyroiditis. Res Rep Endocr Disord. 2013;3:13–5.
11.
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 (Athens). 2005;4:45–8.CrossRef
12.
Svensson J, Ericsson UB, Nilsson P, Olsson C, Jonsson B, Lindberg B, et al. Levothyroxine treatment reduces thyroid size in children and adolescents with chronic autoimmune thyroiditis. J Clin Endocrinol Metab. 2006;91:1729–34.CrossRefPubMed
13.
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;71:451–4.CrossRef
14.
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:e670–4.CrossRefPubMed
15.
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;94:33–7.CrossRefPubMed
16.
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;3:192–7.CrossRefPubMedPubMedCentral
17.
Skarpa V, Kousta E, Tertipi A, Anyfandakis K, Vakaki M, Dolianiti M, et al. Epidemiological characteristics of children with autoimmune thyroid disease. Hormones (Athens). 2011;10:207–4.CrossRef
18.
Radetti G, Gottardi E, Bona G, Corrias A, Salardi S, Loche S, et al. The natural history of euthyroid Hashimoto’s thyroiditis in children. J Pediatr. 2006;149:827–32.CrossRefPubMed
19.
Radetti G, Maselli M, Buzi F, Corrias A, Mussa A, Cambiaso P, et al. 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;76:394–8.CrossRef
20.
Aversa T, Corrias A, Salerno M, Tessaris D, Di Mase R, Valenzise M, et al. Five-year prospective evaluation of thyroid function test evolution in children with Hashimoto's Thyroiditis presenting with either Euthyroidism or subclinical hypothyroidism. Thyroid. 2016;26:1450–6.CrossRefPubMed
21.
Vanderpump MP, Tunbridge WM. Epidemiology and prevention of clinical and subclinical hypothyroidism. Thyroid. 2002;12:839–47.CrossRefPubMed
22.
De Luca F, Corrias A, Salerno M, Wasniewska M, Gastaldi R, Cassio A, et al. Peculiarities of graves’ disease in children and adolescents with Down’s syndrome. Eur J Endocrinol. 2010;162:591–5.CrossRefPubMed
23.
Aversa T, Lombardo F, Corrias A, Salerno M, De Luca F, Wasniewska M. In young patients with turner or down syndrome, Graves’ disease presentation is often preceded by Hashimoto’s thyroiditis. Thyroid. 2014;24:744–7.CrossRefPubMed
24.
Valenzise M, Aversa T, Corrias A, Mazzanti L, Cappa M, Ubertini G, et al. Epidemiology, presentation and long-term evolution of graves’ disease in children, adolescents and young adults with turner syndrome. Horm Res Paediatr. 2014;81:245–50.CrossRefPubMed
25.
Aversa T, Lombardo F, Valenzise M, Messina MF, Sferlazzas C, Salzano G, et al. Peculiarities of autoimmune thyroid diseases in children with turner or down syndrome: an overview. Ital J Pediatr. 2015;41:39.CrossRefPubMedPubMedCentral
26.
Wasniewska M, Aversa T, Salerno M, Corrias A, Messina MF, Mussa A, et al. Five-year prospective evaluation of thyroid function in girls with subclinical mild hypothyroidism of different etiology. Eur J Endocrinol. 2015;173:801–8.CrossRefPubMed
27.
Aversa T, Valenzise M, Salerno M, Corrias A, Iughetti L, Radetti G, et al. Metamorphic thyroid autoimmunity in down syndrome: from Hashimoto’s thyroiditis to graves’ disease and beyond. Ital J Pediatr. 2015;41:87.CrossRefPubMedPubMedCentral
28.
Monzani A, Prodam F, Rapa A, Moia S, Agarla V, Bellone S, et al. Endocrine disorders in childhood and adolescence. Natural history of subclinical hypothyroidism in children and adolescents and potential effects of replacement therapy: a review. Eur J Endocrinol. 2012;168:R1–R11.CrossRefPubMed
29.
Bona G, Prodam F, Monzani A. Subclinical hypothyroidism in children: natural history and when to treat. J Clin Res Pediatr Endocrinol. 2013;5(Suppl 1):23–8.PubMedPubMedCentral
30.
Lazarus J, Brown RS, Daumerie C, Hubalewska-Dydejczyk A, Negro R, Vaidya B. European thyroid association guidelines for the management of subclinical hypothyroidism in pregnancy and in children. Eur Thyroid J. 2014;3:76–94.CrossRefPubMedPubMedCentral
31.
Aversa T, Valenzise M, Corrias A, Salerno M, De Luca F, Mussa A, et al. Underlying Hashimoto's thyroiditis negatively affects the evolution of subclinical hypothyroidism in children irrespective of other concomitant risk factors. Thyroid. 2015;25:183–7.CrossRefPubMed
32.
Lazar L, Frumkin RB, Battat E, Lebenthal Y, Phillip M, Meyerovitch J. Natural history of thyroid function tests over 5 years in a large pediatric cohort. J Clin Endocrinol Metab. 2009;94:1678–82.CrossRefPubMed
33.
Wasniewska M, Corrias A, Aversa T, Valenzise M, Mussa A, De Martino L, et al. Comparative evaluation of therapy with L-thyroxine versus no treatment in children with idiopathic and mild subclinical hypothyroidism. Horm Res Paediatr. 2012;77:376–81.CrossRefPubMed
34.
Aversa T, Messina MF, Mazzanti L, Salerno M, Mussa A, Faienza MF, et al. The association with turner syndrome significantly affects the course of Hashimoto’s thyroiditis in children, irrespective of karyotype. Endocrine. 2015;50:777–82.CrossRefPubMed
35.
Williamson S, Greene SA. Incidence of thyrotoxicosis in childhood: a national population based study in the UK and Ireland. Clin Endocrinol. 2010;72:358–63.CrossRef
36.
Nabhan ZM, Kreher NC, Eugster EA. Hashitoxicosis in children: clinical features and natural history. J Pediatr. 2005;146:533–6.CrossRefPubMed
37.
Wasniewska M, Corrias A, Salerno M, Lombardo F, Aversa T, Mussa A, et al. Outcomes of children with hashitoxicosis. Horm Res Paediatr. 2012;77:36–40.CrossRefPubMed
38.
Donangelo I, Braunstein GD. Update on subclinical hyperthyroidism. Am Fam Physician. 2011;83:933–8.PubMed
39.
Aversa T, Valenzise M, Corrias A, Salerno M, Mussa A, Capalbo D, et al. Subclinical hyperthyroidism when presenting as initial manifestation of juvenile Hashimoto's thyroiditis: first report on its natural history. J Endocrinol Investig. 2014;37:303–8.CrossRef
40.
Rosario PW. The natural history of subclinical hyperthyroidism in patients below the age of 65 years. Clin Endocrinol. 2008;68:491–2.CrossRef
41.
Diez JJ, Iglesias P. An analysis of the natural course of subclinical hyperthyroidism. Am J Med Sci. 2009;337:225–32.CrossRefPubMed
42.
Rosario PW. Natural history of subclinical hyperthyroidism in elderly patients with TSH between 0.1 and 0.4 mIU/l: a prospective study. Clin Endocrinol. 2010;72:685–8.CrossRef
43.
Foley TP Jr, Abbassi V, Copeland KC, Draznin MB. Brief report: hypothyroidism caused by chronic autoimmune thyroiditis in very young infants. N Engl J Med. 1994;330:466–8.CrossRefPubMed
44.
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.CrossRefPubMed
45.
Laurberg P, Cerqueira C, Ovesen L, Rasmussen LB, Perrild H, Andersen S, et al. Iodine intake as a determinant of thyroid disorders in populations. Best Pract Res Clin Endocrinol Metab. 2010;24:13–27.CrossRefPubMed
46.
Ergür AT, Evliyaoğlu O, Şıklar Z, Bilir P, Öcal G, Berberoğlu M. Evaluation of thyroid functions with respect to iodine status and TRH test in chronic autoimmune thyroiditis. J Clin Res Pediatr Endocrinol. 2011;3:18–21.CrossRefPubMedPubMedCentral
Metadata
Title
Thyroid function test evolution in children with Hashimoto’s thyroiditis is closely conditioned by the biochemical picture at diagnosis
Authors
Giuseppe Crisafulli
Romina Gallizzi
Tommaso Aversa
Giuseppina Salzano
Mariella Valenzise
Malgorzata Wasniewska
Filippo De Luca
Giuseppina Zirilli
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Italian Journal of Pediatrics / Issue 1/2018
Electronic ISSN: 1824-7288
DOI
https://doi.org/10.1186/s13052-018-0461-5

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