This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Dan C. Moore, MD

Arch Pediatr Adolesc Med. 1996;150(3):293-297.

Abstract
Objectives
To describe the natural course of "subclinical" hypothyroidism due to autoimmune thyroiditis in children and adolescents, and to determine whether, like euthyroid childhood autoimmune thyroiditis, it would also run a more benign course in this age group than in adults.

Design
Case series.

Setting
Pediatric endocrine clinic in a tertiary medical center.

Patients
Eighteen patients (age range, 5 to 19 years) with juvenile autoimmune thyroiditis and an initially elevated serum thyrotropin (thyroid-stimulating hormone) concentration were followed up from documentation of the elevated serum thyrotropin concentration for a mean of 5.8 years. Eleven patients never received treatment, and seven were followed up after discontinuation of therapy.

Main Outcome Measures
Changes in the serum thyrotropin and thyroxine concentrations and thyroid gland size, as well as signs and symptoms of hypothyroidism, were monitored throughout the observation period.

Results
The mean duration of observation during which the patients did not receive any therapy was 47.3 months. At the end of the observation period, seven patients were euthyroid, 10 continued to have an elevated serum thyrotropin concentration with a normal serum thyroxine concentration, and one became hypothyroid.

Conclusions
"Subclinical" juvenile hypothyroidism may be a benign and remitting process in many older children and adolescents. In view of the undefined risks of levothyroxine sodium therapy, it may be possible to follow up expectantly selected younger patients with a minimally elevated serum thyrotropin concentration, rather than to treat them empirically.

(Arch Pediatr Adolesc Med. 1996;150:293-297)

Author Affiliations
From the Department of Clinical Investigation, Madigan Army Medical Center, Tacoma, Wash.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Natural History of Thyroid Function Tests over 5 Years in a Large Pediatric Cohort
Lazar et al.
J. Clin. Endocrinol. Metab. 2009;94:1678-1682.
ABSTRACT | FULL TEXT  

Prospective evaluation of the natural course of idiopathic subclinical hypothyroidism in childhood and adolescence
Wasniewska et al.
Eur J Endocrinol 2009;160:417-421.
ABSTRACT | FULL TEXT  

Chronic autoimmune thyroiditis in children and adolescents: at presentation and during long-term follow-up
de Vries et al.
Arch. Dis. Child. 2009;94:33-37.
ABSTRACT | FULL TEXT  

The Clinical Significance of Subclinical Thyroid Dysfunction
Biondi and Cooper
Endocr. Rev. 2008;29:76-131.
ABSTRACT | FULL TEXT  

Natural course of autoimmune thyroiditis in type 1 diabetes: association with gender, age, diabetes duration, and puberty
Kordonouri et al.
Arch. Dis. Child. 2005;90:411-414.
ABSTRACT | FULL TEXT  

Subclinical hypothyroidism and Down's syndrome; studies on myocardial structure and function
Toscano et al.
Arch. Dis. Child. 2003;88:1005-1008.
ABSTRACT | FULL TEXT  

Resting Energy Expenditure is Sensitive to Small Dose Changes in Patients on Chronic Thyroid Hormone Replacement
Al-Adsani et al.
J. Clin. Endocrinol. Metab. 1997;82:1118-1125.
ABSTRACT | FULL TEXT