title: Five-Year Prospective Evaluation of Thyroid Function Test Evolution in Children with Hashimoto's Thyroiditis Presenting with Either Euthyroidism or Subclinical Hypothyroidism.
abstract: Whether the course of thyroid function in Hashimoto's thyroiditis (HT) differs in children who present with either euthyroidism or subclinical hypothyroidism (SH) has been incompletely investigated.
  
  
  
  Using a five-year prospective evaluation of 234 children with HT and no prognostic risk factors, this study investigated whether the evolution of the thyroid status is influenced by the biochemical pattern at initial diagnosis.
  
  
  
  In the entire series, thyrotropin values significantly increased during follow-up, while free thyroxine values decreased and the proportion of children with a thyroid dysfunction increased from 27.3% to 47.4% (p = 0.0001). An increasing proportion of cases with severe thyroid dysfunction was identified, especially among the 64 patients presenting with SH (group B), but also among the 170 children presenting with euthyroidism (group A) at initial diagnosis. At the end of follow-up, the prevalence of children with overt hypothyroidism was 12.3% in group A compared with 31.2% in group B (p = 0.0007). In the overall population, however, the majority of patients (52.6%) exhibited biochemical euthyroidism at the end of follow-up.
  
  
  
  Children with HT may develop a deterioration of thyroid status during the first five years of disease. Such a trend may be observed, even in the patients who initially present with a mild biochemical picture (either SH or euthyroidism). A total of 57.1% of initially euthyroid children remain euthyroid, and 40.6% of patients with initial SH normalize thyroid function within five years after HT diagnosis. The patients presenting with SH are more prone to the risk of developing severe thyroid dysfunction over time.
authors.affiliation: 1 Department of Pediatrics, University of Messina , Messina, Italy .
authors.forename: Tommaso
authors.initials: T
authors.lastname: Aversa
authors.affiliation: 2 Department of Pediatrics, University of Turin , Regina Margherita Children's Hospital, Turin, Italy .
authors.forename: Andrea
authors.initials: A
authors.lastname: Corrias
authors.affiliation: 3 Department of Pediatrics, University "Federico II ," Naples, Italy .
authors.forename: Mariacarolina
authors.initials: M
authors.lastname: Salerno
authors.affiliation: 2 Department of Pediatrics, University of Turin , Regina Margherita Children's Hospital, Turin, Italy .
authors.forename: Daniele
authors.initials: D
authors.lastname: Tessaris
authors.affiliation: 3 Department of Pediatrics, University "Federico II ," Naples, Italy .
authors.forename: Raffaella
authors.initials: R
authors.lastname: Di Mase
authors.affiliation: 1 Department of Pediatrics, University of Messina , Messina, Italy .
authors.forename: Mariella
authors.initials: M
authors.lastname: Valenzise
authors.affiliation: 1 Department of Pediatrics, University of Messina , Messina, Italy .
authors.forename: Domenico
authors.initials: D
authors.lastname: Corica
authors.affiliation: 1 Department of Pediatrics, University of Messina , Messina, Italy .
authors.forename: Filippo
authors.initials: F
authors.lastname: De Luca
authors.affiliation: 1 Department of Pediatrics, University of Messina , Messina, Italy .
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Wasniewska
mesh_terms: D000293:Adolescent; D058070:Asymptomatic Diseases / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D050031:Hashimoto Disease / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D007037:Hypothyroidism / Q000453:epidemiology / Q000209:etiology*; D007558:Italy / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012306:Risk; D012720:Severity of Illness Index; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000378:metabolism / Q000503:physiopathology*; D013972:Thyrotropin / Q000097:blood / Q000378:metabolism; D013974:Thyroxine / Q000097:blood / Q000378:metabolism
chemical_list: D013972:Thyrotropin; D013974:Thyroxine