406 Epidemiological Characteristics of Children and Adolescents with Autoimmune Thyroid Disease

Abstract

Background/objective: Chronic autoimmune thyroiditis is the most common cause of thyroid dysfunction in children. The epidemiological and clinical characteristics of AT among children differ widely between studies.To investigate children with AT attending a major Pediatric Endocrinology Unit in Athens.Methods: Characteristics of 228 children and adolescents (mean±SD age: 10.2±2.5yrs) with AT were assessed retrospectively over ten years. Reasons for referral, family history of thyroid / other autoimmune disease and growth data were recorded. Laboratory evaluation and thyroid U/S scan was carried out in all patients. The patients' characteristics were analysed separately in three groups (euthyroid, subclinical hypothyroid and hypothyroid).Results: Main reasons for referral included growth evaluation (23%), goiter (18%) and positive family history (17%).174 patients (76,3%) had positive family history and 15(6,6%) an additional autoimmune disease.191 (83.8%) were female and 142 (62.3%) pubertal. Among the 228 children, 130 (57.0%) were euthyroid, 75 (32.9%) had subclinical hypothyroidism, 19 (8.3%) hypothyroidism and 4 (1.8%) hyperthyroidism. There was a positive correlation between TSH and thyroid volume SDS (r=0.15, p=0.02). Children with hypothyroidism had higher thyroid volume SDS (3.1±1.9 vs 1.2±1.2 p< 0.05) than euthyroid children. Sixty three children (28%) had goiter and 32(14%) had thyroid nodules. Three patients developed papillary carcinoma.Conclusion: Children and adolescents with AT are mostly asymptomatic; the majority are female, pubertal and euthyroid. Hypothyroid children have higher thyroid volume and increased prevalence of goiter compared to euthyroid children. Diagnosing AT at an early stage gives the opportunity to implement therapeutic measures aiming to prevent disease progression.