Natural course of juvenile autoimmune thyroiditis

Mäenpää, J; Raatikka, Marja; Räsänen, Jorma A.; Taskinen, Eero; Wäger, O

doi:10.1016/s0022-3476(85)80183-9

Cited by 59 publications

(28 citation statements)

References 20 publications

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“…This is compatible with the general finding that autoimmune thyroiditis in children is usually benign and without symptoms of hypo-or hyperthyroidism despite slightly elevated TSH levels (43). Spontaneous remission without treatment is frequent (44,45).…”

Section: Discussionsupporting

confidence: 89%

The prevalence of anti-thyroid peroxidase antibodies and autoimmune thyroiditis in children and adolescents in an iodine replete area

Kabelitz

Liesenkötter²,

Stach³

et al. 2003

European Journal of Endocrinology

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Background: The iodine supply of the population in Berlin has normalized during the last 5 years. Therefore autoimmune thyroiditis has become the most important differential diagnosis in children and adolescents with goiter. Objective: The aim of the present study was to define the prevalence of anti-thyroid peroxidase (TPO) antibodies and autoimmune thyroiditis in children and adolescents with a normalized iodine intake. Design: To enable the measurement of antibodies to thyroid peroxidase (anti-TPO-Ab) in a large cohort, a method to determine anti-TPO-Ab in dried filter paper blood spots was established. In co-operation with pediatricians the antibody prevalence was assessed and data regarding thyroid size, echostructure and the medical history concerning iodine intake and familial thyroid diseases were collected. Methods: 660 children and adolescents participated in the study; urinary iodine, TSH and TPO-Ab were measured and an ultrasound of the thyroid gland was performed. Results: The sensitivity of the newly established filter paper assay was 91.8% and specificity was 100%. The results confirmed the improved iodine supply, with a median urinary iodine concentration of 139 mg iodine/g creatinine. The prevalence of anti-TPO-Ab was 3.4% with a female to male ratio of 2.7:1. Conclusion: The prevalence of anti-TPO-Ab is lower or equal to data reported from other iodine sufficient areas. Data from a moderate iodine deficiency in schoolchildren range from 0.0 to 7.3%. Using the new filter paper method field studies can be implemented to monitor the effect of changes in iodine nutrition on thyroid autoimmunity. Furthermore, this study on the prevalence of anti-TPO-Ab in a cohort of healthy children and adolescents in an iodine replete area can serve as reference data for future investigations and for the comparison with other groups of patients with increased risks for thyroid autoimmunity.

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Section: Discussionsupporting

confidence: 89%

The prevalence of anti-thyroid peroxidase antibodies and autoimmune thyroiditis in children and adolescents in an iodine replete area

Kabelitz

Liesenkötter²,

Stach³

et al. 2003

European Journal of Endocrinology

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“…Such results are corroborated by Roth et al (22), Poropatich et al (28), and Droese et al (29). Finally, it is recognized that antibody titers might change but cytomorphological features persist during the clinical course of HT (30). Our data, along with the above studies, indicate the need to combine cytological and serological evaluation to diagnose JAT.…”

Section: Discussionsupporting

confidence: 52%

Hashimoto’s Thyroiditis: Countrywide Screening of Goitrous Healthy Young Girls in Postiodization Phase in India¹

Marwaha¹,

Tandon²,

Karak³

et al. 2000

The Journal of Clinical Endocrinology & Metabolism

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Countrywide salt iodization, to prevent nutritional iodine deficiency, has been achieved in India recently. The current study was planned to evaluate the prevalence of goiter and thyroid autoimmunity and assess thyroid functional status in a cohort of 6283 healthy schoolgirls from different parts of the country in the postiodization phase. Goitrous girls (n ϭ 1810; 28% of subjects) were investigated for serum T 4 and TSH, antithyroid microsomal antibody (TMA) and antithyroglobulin antibody (TGA), urinary iodine excretion, and cytomorphology by fine-needle aspiration cytology (FNAC). FNAC carried out successfully in 764 goitrous girls revealed juvenile autoimmune thyroiditis (JAT) in 58 (7.5%), which included Hashimoto's thyroiditis in 43 (5.6%) and focal lymphocytic thyroiditis in 15 (1.9%). TMA and TGA estimated in 722 goitrous girls detected significantly positive titers of TMA (Ն1:1600) and TGA (Ն1:160) in 52 (7.2%) and 4 (0.55%) girls, respectively. Only 29 (67.4%) girls with Hashimoto's thyroiditis were TMA positive.In patients with FNAC-proven JAT, overt clinical and biochemical hypothyroidism was seen in three (6.5%) and subclinical hypothyroidism in seven (15%). Subclinical hyperthyroidism was detected in 5.1% cases of JAT, and none had overt hyperthyroidism. No definite correlation was seen between urinary iodine excretion and thyroid autoimmunity. (J Clin Endocrinol Metab 85: 3798 -3802, 2000)

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“…The natural course of AT is highly variable among children and adolescents [7,9,18,19,20]. Mäenpää et al [18] in Finland followed up 46 children and adolescents with AT for 6.5 years and found a variable natural course with regard to thyroid size and hormone status.…”

Section: Discussionmentioning

confidence: 99%

“…Mäenpää et al [18] in Finland followed up 46 children and adolescents with AT for 6.5 years and found a variable natural course with regard to thyroid size and hormone status. In 24% of the patients the thyroid size remained unchanged, in 50% it decreased and in 26% it increased [18].…”

Section: Discussionmentioning

confidence: 99%

Treatment with Thyroxine Reduces Thyroid Volume in Euthyroid Children and Adolescents with Chronic Autoimmune Thyroiditis

Scarpa

Kousta²,

Tertipi³

et al. 2010

Horm Res Paediatr

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Background/Aims: Treatment with thyroxine in children with chronic autoimmune thyroiditis (AT) is controversial. The aim of this study is to investigate, by using thyroid ultrasonography, whether thyroxine influences thyroid volume in non-goitrous euthyroid children with AT. Methods: We studied 50 euthyroid non-goitrous children and adolescents with AT for 2 years by thyroid function tests and ultrasonography; 25 were randomized to receive thyroxine and 25 did not receive treatment. Median (IQR) age was 12.1 (11.1–13.2) years. Results: At baseline there was no difference in thyroid volume SDS between the two groups (treatment group 1.1 (0.7–1.5) and controls 0.9 (0.4–1.4), respectively). After 2 years the treatment group had lower thyroid volume SDS compared to the controls (0.6 (0.3–1.0) vs. 2.0 (1.1–2.3), p = 0.001). One child of the treatment group and 12 of the control group developed goiter. Two control children developed subclinical hypothyroidism. Within the treatment group, thyroid volume SDS was lower after 2 years of treatment (p = 0.002). Within the control group, thyroid volume SDS and TSH levels increased after 2 years of follow-up (p = 0.016, 1.9 (1.5–2.8) vs. 3.2 (2.4–4.4) mIU/ml, p = 0.006, respectively). Conclusions: Treatment with thyroxine reduces thyroid volume in non-goitrous euthyroid children with AT and may prevent goiter development.

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Natural course of juvenile autoimmune thyroiditis

Cited by 59 publications

References 20 publications

The prevalence of anti-thyroid peroxidase antibodies and autoimmune thyroiditis in children and adolescents in an iodine replete area

The prevalence of anti-thyroid peroxidase antibodies and autoimmune thyroiditis in children and adolescents in an iodine replete area

Hashimoto’s Thyroiditis: Countrywide Screening of Goitrous Healthy Young Girls in Postiodization Phase in India¹

Treatment with Thyroxine Reduces Thyroid Volume in Euthyroid Children and Adolescents with Chronic Autoimmune Thyroiditis

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Natural course of juvenile autoimmune thyroiditis

Cited by 59 publications

References 20 publications

The prevalence of anti-thyroid peroxidase antibodies and autoimmune thyroiditis in children and adolescents in an iodine replete area

The prevalence of anti-thyroid peroxidase antibodies and autoimmune thyroiditis in children and adolescents in an iodine replete area

Hashimoto’s Thyroiditis: Countrywide Screening of Goitrous Healthy Young Girls in Postiodization Phase in India1

Treatment with Thyroxine Reduces Thyroid Volume in Euthyroid Children and Adolescents with Chronic Autoimmune Thyroiditis

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Hashimoto’s Thyroiditis: Countrywide Screening of Goitrous Healthy Young Girls in Postiodization Phase in India¹