Differentiation of chronic lymphocytic thyroiditis and simple goiter in pediatrics

Monteleone, James A.; Danis, Richard K.; Tung, Kenneth S. K.; Ramos, Carlos V.; Peden, Virginia H.

doi:10.1016/s0022-3476(73)80259-8

Cited by 18 publications

(10 citation statements)

References 8 publications

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“…There is a significant danger of late hypothyroidism, often with vascular sequelae, in untreated A-IT (Saxena & Crawford, 1962;Papapetrou et al, 1972;Gordin & Lamberg, 1975). Persson (1967) and the present paper show the value of thyroxine supplements in decreasing goitre size in autoimmune thyroiditis and its relative lack of value in simple colloid goitre.…”

Section: Discussionmentioning

confidence: 56%

“…In juvenile A- IT Ling et al (1969) found 63% positivity. Monteleone et al (1973) and Tung et al (1 974) surprisingly reported 100% accuracy in distinguishing simple goitre from A-ITin children, using this test. In our series the IF test offered no significant advantage over the CFT-81% versus 79%.…”

Section: Discussionmentioning

confidence: 79%

“…Large-needle (Vim-Silverman) biopsy for histology has been recommended by several authors. Very good results have been reported by some (Beahrs et al, 1962;Hahn et al, 1965) whereas others have found it difficult t o obtain satisfactory material (Persson, 1967, Monteleone et al, 1973. Large-needle biopsy requires local anaesthesia and sometimes general anaesthesia (Ling etal., 1969); significant haematoma occurs occasionally and patient acceptability is not universal.…”

Section: Discussionmentioning

confidence: 99%

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Non‐toxic Goitre: Diagnostic Role of Aspiration Cytology, Antibodies and Serum Thyrotrophin

Gutteridge

Orell

1978

Clinical Endocrinology

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Fifty cases of bilateral non-toxic goitre, largely unselected, have been studied using fine needle aspiration cytology (without local anaesthesia); four techniques of thyroid antibody tests; serum thyroid biochemistry (including radioimmunoassay of TSH) and clinical evaluation. Autoimmune thyroiditis was found cytologically in 64%; simple colloid goitre in 24%; subacute thyroiditis of de Quervain in 10%. Aspiration cytology was the most sensitive means of detecting autoimmune thyroiditis and subacute thyroiditis. Two antibodies directed against the intra-cellular cytoplasmic antigen--the complement fixation test and an immunofluorescent antibody were of lesser value in detecting autoimmune thyroiditis (80% positivity) though equal to each other. Serum TSH was of some value--being elevated in 63% of cases of autoimmune thyroiditis and in no cases of simple colloid goitre. Two major cytological subtypes of autoimmune thyroiditis have been described--with significant differences in duration of goitre, mode of presentation, frequency of hypothyroidism, and response to thyroxine therapy. The high frequency of autoimmune thyroiditis in this series suggests that endemic goitre is unlikely in Western Australia.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

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Non‐toxic Goitre: Diagnostic Role of Aspiration Cytology, Antibodies and Serum Thyrotrophin

Gutteridge

Orell

1978

Clinical Endocrinology

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“…Unusual presentations included headi. aches (patient 14), vaginal bleeding (patient 3), and hip pain (patient 17). In this last patient with hypothyroidism of 8 years' duration, marked epiphyseal dysgenesis was present and was the cause of the hip pain.…”

Section: Resultsmentioning

confidence: 77%

Clinical Recognition of Juvenile Hypothyroidism in the Early Stage

Abbassi

Rigterink

Cancellieri

1980

Clin Pediatr (Phila)

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The clinical manifestations of biochemically-confirmed acquired hypothyroidism in nineteen children and adolescents were reviewed to evaluate the symptoms and signs in the early stage of the disease. The group consisted of 14 girls and 5 boys ranging in age from 4 to 15 years. In 13 of the 19 patients with profound biochemical hypothyroidism, classical symptoms were often absent and clinical signs limited. In these patients, hypothyroidism was presumed to have been short in duration and consequence of chronic lymphocytic thyroiditis. In the remaining 6 patients, hypothyroidism was long-standing and clinical presentation classical, including disproportionate weight gain, fatigue, cold intolerance, myxedematous feature, growth retardation and constipation. Goiter was the most consistent finding in both groups and was present in all instances of spontaneously acquired primary hypothyroidism. These observations emphasize the importance of routine examination of the thyroid gland, particularly in preadolescent and adolescent girls. The finding of goiter may be the only detectable sign of hypothyroidism in the early stage of the disease. Biochemical evaluation should not be deferred because of a clinically euthyroid presentation. Replacement therapy must be instituted when findings indicate a hypothyroid state. Failure to recognize and treat hypothyroidism in these pubertal patients may compromise the adult height, since skeletal maturation will proceed under the influence of sex hormones despite the presence of hypothyroidism.

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“…Although, there is no clear explanation for the peculiar age distribution of positive anti-thyroid antibodies reported here, it is of interest that the incidence of asymptomatic goitre follows a similar age distribution (Matovinovic et al 1965). On the ohter hand, there is extensive evidence suggesting that Hashimoto's thyroiditis is a frequent cause of goitre in childhood (Ling et al 1969;Hung et al 1973;Monteleone et al 1973;Rallison et al 1975). …”

Section: Discussionmentioning

confidence: 99%

Alterations in serum thyroid hormones in euthyroid children with circulating anti-thyroid antibodies

Villalpando

Cisneros

García-Bulnes

et al. 1982

Acta Endocrinologica

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Anti-thyroid antibodies are frequently found in otherwise normal populations (4.5\p=n-\25.8%);however, there is scanty information about thyroid function status in affected individuals. In this report, the serum concentrations of TSH, T3, T4, rT3 and TBG and the titre of anti-thyroglobulin and anti-microsomal antibodies (haemagglutination technique) were studied in 520 healthy school children (260 boys and 260 girls) aged 6.0\p=n-\17.9 years. Titres equal or greater than 1:16 of one or both antibodies were detected in 58 boys and in 77 girls (in 33 boys and in 24 girls with, and in 25 boys and 43 girls without, associated abnormalities in the serum concentrations of one or several hormones). The age distribution of thyroid antibodies followed a trimodal pattern with peaks at 7, 11 and 16\p=n-\17 years in both sexes. The most striking finding was an abnormally elevated T3 concentration in 22 boys and 5 girls with positive antibodies, with no symptoms of thyroid dysfunction and with no clear relationship with simultaneous abnormalities in TSH, T4 or rT3; however, in 5 boys the TBG serum levels were increased. Serum from these patients was incubated with [125I]T3 before free radioactivity was precipitated with dextran-coated charcoal and the aliquots were analyzed by paper electrophoresis. Serum samples with high T3 levels bound significantly more radioactivity than normal or T3-free serum (P < 0.001) and an abnormal peak of radioactivity was present in the gamma globulin fraction, in the former but not in the latter two types of sera. The presence of high serum T3 levels in the absence of clinical symptoms of hyperthyroidism was probably due to sequestration of T3 by the anti-thyroglobulin antibody, which may have cross-reactivity with T3 and T4, as has previously been demonstrated both in animals and humans.

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Differentiation of chronic lymphocytic thyroiditis and simple goiter in pediatrics

Cited by 18 publications

References 8 publications

Non‐toxic Goitre: Diagnostic Role of Aspiration Cytology, Antibodies and Serum Thyrotrophin

Non‐toxic Goitre: Diagnostic Role of Aspiration Cytology, Antibodies and Serum Thyrotrophin

Clinical Recognition of Juvenile Hypothyroidism in the Early Stage

Alterations in serum thyroid hormones in euthyroid children with circulating anti-thyroid antibodies

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