TESTING FOR THYROID-FUNCTION RECOVERY IN CHILDREN AND ADOLESCENTS WITH HASHIMOTO THYROIDITIS

Thyroid function in children and adolescents with primary hypothyroidi sm owing to Hashimoto thyroiditis was studied to evaluate criteria for the discontinuation of thyroxine therapy. A cohort of 29 children and adolescents was prospectively studied for one year. A thyrotropin-rel easing hormone stimulation test with measurements of basal and stimula ted thyrotropin and thyroxine was performed at the beginning of the st udy and 6 and 12 months later. In 59 percent of patients, persistent b iochemical evidence of hypothyroidism was observed. Interindividual va riations and variations among measurements in individual patients were much greater than those reported for healthy individuals. In one pati ent, all measured values were consistently normal, and the therapy was successfully discontinued. No single measurement or test could predic t the natural course of disease. In summary, children and adolescents with hypothyroidism owing to Hashimoto thyroiditis can not have discon tinued replacement thyroxine therapy on the basis of any single evalua tion of thyroid function, as proposed for adults. If the decision to d iscontinue the therapy in this age group is made on the basis of previ ous follow-up, a substantial possibility of relapse remains and contin uous follow up is necessary.