SubHypo+antistoffen versus subhypo-antistoffen bij kinderen

[Kiek]

Er is nog geen onderzoek gedaan naar de evolutie van soorten subklinische hypothyreoïdeën bij kinderen.
Daarom pakte de groep van Tommase Aversa dit onderwerp op.

Hoe ontwikkelt zich een Hashimoto subklinische hypothyreoïdie bij kinderen, als je dat vergelijkt met kinderen met een subklinische hypothyreoïdie waarvan de oorzaak onbekend is?

Uit dit 2 jaar durend vergelijkend onderzoek blijkt dat de TSH van de Hashimoto-kinderen vaker stijgt. Ook worden Hashimoto-schildklieren vaker groter.

De kans om spontaan een goede schildklierfunctie te krijgen is weer groter bij de kinderen met een subklinische hypo van onbekende oorzaak.


Underlying Hashimoto’s thyroiditis negatively affects the evolution of subclinical hypothyroidism in children irrespectively of other concomitant risk factors No Access

Tommaso Aversa, Mariella Valenzise, Andrea Corrias, Mariacarolina Salerno, Filippo De Luca, Alessandro Mussa, Martina Rezzuto, Fortunato Lombardo, Malgorzata Wasniewska

Thyroid November 2014
http://www.liebertpub.com/thy


Background: The pediatric literature includes no studies comparing the evolution of Hashimoto’s thyroiditis (HT)-related subclinical hypothyroidism (SH) compared idiopathic SH longitudinally. Aim and design: In the present study, we investigated the 2-year evolution of HT-related SH in 32 children with no concomitant risk factors (group A) compared to that observed in 90 age–matched children with idiopathic SH (group B). Our aim was to ascertain whether the association with HT could, per se, affect the evolution of thyroid status over time in SH children irrespectively of other coexisting factors, such as thyromegaly, association with other autoimmune diseases, and/or concomitant therapies. Results: During the 2-year follow-up, the percentage of children whose TSH values increased above 10 mU/l was significantly higher in group A (p<0.0005), whereas the percentages of those who either maintained a stable TSH (5-10 mU/l) or normalized the TSH (<5 mU/l) were significantly higher in group B (p<0.025 for both cases).

Moreover, the percentage of children who developed a pathological thyroid enlargement during follow-up was significantly higher in group A (p<0.0005). Conclusions: a) The association with HT exerts, per se, a negative influence on the evolution over time of mild SH, irrespectively of other concomitant risk factors; b) in the children with mild and HT–related SH the risk of a thyroid status deterioration over time is high (53.1%), whilst the probability of a spontaneous TSH normalization is relatively low (21.9%); c) in contrast, in the children with mild and idiopathic SH, the risk of a thyroid status deterioration over time is very low (11.1%), whereas the probability of a spontaneous TSH normalization is high (41.1%).