Juvenile autoimmune thyroiditis. Hormonal status at presentation and after long-term follow-up
C. A. Sklar, R. Qazi and R. David
Thirty children and adolescents with the clinical diagnosis of juvenile
autoimmune thyroiditis (JAT) were studied. Twenty-six patients were female
and four were male. The median age at diagnosis was 12.9 years (range, 7.5
to 17.3 years). At the initial evaluation, endocrine studies revealed that
40% of the patients were euthyroid, while 33% had compensated
hypothyroidism and 27% had overt hypothyroidism. Seventeen patients, 16 of
whom received thyroid hormone replacement therapy for a median period of 26
months, were followed up on a long-term basis after discontinuation of
therapy. Seven (87%) of eight patients who were initially euthyroid have
remained so for a median period of 28 months after treatment and a median
period of 50 months since diagnosis. Four (44%) of nine patients who
initially had hypothyroidism (either compensated or overt) have reverted to
a euthyroid state and have remained so for a median period of 33 months
after discontinuation of therapy. Neither the size of the thyroid gland nor
the pattern or absolute titer of thyroid autoantibodies correlated with
functional status. These results indicate that individuals with euthyroid
JAT may remain euthyroid for many years and that a substantial percentage
of patients with hypothyroid JAT will experience resolution of thyroid
dysfunction.
