Autoimmune thyroiditis: clinical and laboratory findings in 34 patients

Autoimmune thyroiditis (AT) is the most common cause of nonendemic thyromeg aly and aquired hypothyroidism in childhood and adolescence. Outgoing from an increasing number of newly diagnosed patients during the last years we p erformed a retrospective analysis including 34 patients treated between 198 9 and 1998. Clinical data, laboratory and sonographical findings are descri bed. Cases were ascertained by palpable thyroid enlargement or clinical sig ns of thyroid dysfunction and positive autoantibodies against thyroid tissu e. Frequency of AT diagnosis has threefold increased since 1995 in our departm ent. Age at diagnosis was 5.4 to 16.3 years (median 11.3). Palpable thyrome galy was present in 29 (85%) of our patients. Three patients had myxedema w ithout goiter. Symptoms had been present for a period between 6 weeks and 7 .5 years: median in all patients 6 months, median in hypothyroid patients 9 months. At time of diagnosis 15 patients suffered from hypothyroidism, 3 f rom hyperthyroidism and 7 patients showed normal levels of thyroid hormones . In 9 patients we found an isolated elevation of thyrotropin. 12 patients were prepubertal (Tanner 1), 15 patients were pubertal (Tanner II-IV). 5 pa tients showed a dissociation of pubertal maturation. Ultrasound of thyroid gland showed an inhomogeneous and hypoechoic pattern in 32 patients. 30 pat ients were treated with thyroxine. Patients with persistent hyperthyroidism were treated with carbimazol. During the follow-up period enlargement of t he thyroid gland decreased in one third of the patients. Thyromegaly caused by autoimmune thyroiditis gets an increasing importance. The high degree of obviously hypothyroid patients at the time of diagnosis reflects a delay of diagnosis. Early recognition and treatment of the dise ase should be achieved far a preventive care of hypothyroidism.