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Hashimoto’s thyroiditis deteriorates thyroid status within 5 years
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Children with Hashimoto’s thyroiditis who are euthyroid or have subclinical hypothyroidism at diagnosis may develop overt hypothyroidism during the first 5 years of disease, study data show.
Filippo De Luca, MD, of the department of pediatrics at the University of Messina in Italy, and colleagues evaluated 234 children with Hashimoto’s thyroiditis and no prognostic risk factors. Participants were divided into two groups based on biochemical thyroid status: euthyroidism (n = 170) or subclinical hypothyroidism (n = 64).
“The aim of the present study was to investigate, by means of a 5-year prospective evaluation, whether the evolution of the thyroid status is influenced by the biochemical pattern at initial diagnosis,” the researchers wrote.
Median thyroid-stimulating hormone levels were higher and mean free thyroxine levels were lower in the group with subclinical hypothyroidism compared with the euthyroid group.
The number of participants with euthyroidism at baseline decreased over time (P = .0001), whereas the number of participants who developed overt hypothyroidism increased (P = .0001).
There was no significant change in the percentage of participants with either subclinical hypothyroidism or hyperthyroidism during follow-up. However, during follow-up, the percentage of participants with a thyroid dysfunction increased from 27.3% to 47.4% (P = .0001).
Among participants in the subclinical hypothyroidism group, 26 became euthyroid, 20 developed overt hypothyroidism, 16 remained with subclinical hypothyroidism and two shifted from having Hashimoto’s thyroiditis to Graves’ disease.
At the end of follow-up, 12.3% of participants originally euthyroid developed overt hypothyroidism compared with 31.2% of the subclinical hypothyroid group (P = .0007).
“Children with [Hashimoto’s thyroiditis] may develop a deterioration of thyroid status during the first 5 years of disease,” the researchers wrote. “Such a trend may be observed, even in the patients who initially present with a mild biochemical picture (either [subclinical hypothyroidism] or euthyroidism). A total of 57.1% of initially euthyroid children remain euthyroid, and 40.6% of patients with initial [subclinical hypothyroidism] normalize thyroid function within 5 years after [Hashimoto’s thyroiditis] diagnosis. Patients presenting with [subclinical hypothyroidism] are more prone to the risk of developing severe thyroid dysfunction over time.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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