[Chronic autoimmune thyroiditis in the child].
OBJECTIVE
The aim of the study was to describe the clinical characteristics and long-term follow-up of a group of children with chronic autoimmune thyroiditis.


METHODS
Sixty children (age: 11.9 +/- 2.7 years) were studied in a retrospective analysis.


RESULTS
At diagnosis, 34 of the children were hypothyroid (compensated hypothyroidism, n = 15; true hypothyroidism, n = 19) and 26 euthyroid. Thyroid ultrasonography showed characteristic features of heterogenicity and/or hypoechogenicity in all patients. Other autoimmune diseases were found in ten subjects (17%) and 23% had a family history of thyroid disease. At the end of the follow-up, nine of 45 children (20% of the cases) followed up for at least one year (mean follow-up 4.4 +/- 3.7 years), demonstrated a change in thyroid function. Hypothyroidism was detected in two initially euthyroid patients. Among initially hypothyroid patients, seven (28%) recovered normal thyroid function, allowing L-thyroxine withdrawal for four weeks, after 1.5 to 8.4 years. No factor was found to be predictive of the course of the disease. All subjects treated with L-thyroxine for hypothyroidism reached normal final height.


CONCLUSIONS
The natural course of chronic lymphocytic thyroiditis is variable and unpredictable. Recovery from hypothyroidism does occur and can be aided by the L-thyroxine withdrawal test. The disease requires lifelong thyroid surveillance, especially in women during pregnancy, in order to avoid a potential adverse effect on the future child.
Marinovic
D
D
Service d'endocrinologie et diabétologie pédiatriques, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France.
Léger
J
J
Garel
C
C
Czernichow
P
P
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007037:Hypothyroidism / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control; D011379:Prognosis; D012189:Retrospective Studies; D013967:Thyroiditis, Autoimmune / Q000473:pathology*; D013974:Thyroxine / Q000627:therapeutic use*
D013974:Thyroxine