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Year : 2020  |  Volume : 17  |  Issue : 1  |  Page : 7-13

Pattern of autoimmune thyroiditis in Egyptian children and adolescence

1 Pediatric Endocrinology Unit, Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt
2 Undergraduate Medical Student, Armed Forces College of Medicine, Cairo, Egypt

Correspondence Address:
Prof. Kotb Abbass Metwalley
Pediatric Endocrinology Unit, Department of Pediatrics, Faculty of Medicine, Assiut University, B.O. 71111, Assiut
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/trp.trp_5_20

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Background: Autoimmune thyroiditis (AIT) is the most common thyroid disorder in the pediatric age range. Aim: The aim of the retrospective study is to analyze the demographic, clinical, ultrasonographical, hormonal, immunological, and histopathological characteristics of 362 children and adolescents with a diagnosis of AIT. Patients and Methods: Data relating to the patient demographic and clinical characteristics both on presentation and during follow-up were collected. We also analyzed the investigations performed; these included thyroid function tests, immunological, radiological, and fine-needle aspiration biopsy (FNAB) results. Results: Patients' age ranged from 8.2 to 16.5 years and a female: male ratio of 5.1:1. The common presenting features were goiter and short stature (138 [38.1%] and 68 [18.7%], respectively). At diagnosis, 83 (22.9%), 23 (6.3%), and 256 (67.0%) patients were euthyroid, subclinical hypothyroid, and overt hypothyroid, respectively. High-resolution thyroid ultrasound revealed higher rate of nodular pattern compared to clinical examination (17 vs. 13 for single nodule and 6 vs. 4 for multiple nodules). Fine-needle aspiration of the thyroid gland was performed in 12 patients; none of them was malignant. Patients were followed for a mean period of 38 months (range: 6–45 month). Only 3 (13%) patients with subclinical hypothyroidism progressed to overt hypothyroidism, and started on L thyroxine therapy, while the rest of the case had stationary course. Conclusions: Our study reported the highest rate (68.7%) of overt hypothyroidism compared with other studies. The study reported that AIT in children and adolescents has benign course. Thyroid ultrasound can identify clinically unapparent thyroid nodules and play an important role in the selection of cases for FNAB. Careful follow-up of thyroid function is important to determine the necessity and timing of L-thyroxine replacement therapy.

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