Demographic and Clinical Characteristics of Childhood Autoimmune Thyroiditis: Single-Center Study

Abstract

Aim: This study aimed to evaluate the clinical characteristics of pediatric patients diagnosed with autoimmune thyroiditis (AIT) at a tertiary healthcare center. Materials and Methods: We conducted a retrospective study of 155 children diagnosed with AIT at a pediatric endocrinology clinic between January 1st, 2014 and December 31st, 2022. Clinical data were obtained through a comprehensive medical record review. Results: The study population showed a strong female predominance (87.7%), with most patients (78.1%) being 10 years or older at diagnosis. The most common presenting symptom was neck swelling (23.2%), while 38.7% were asymptomatic at diagnosis. A family history of thyroid disease was present in 37.4% of the cases, and the majority of patients (76.0%) were pubertal at diagnosis. Thyroid function at presentation revealed subclinical hypothyroidism in 40.0%, euthyroidism in 33.5%, overt hypothyroidism in 22.6%, and hyperthyroidism in 3.9% of the patients. Anti-thyroid antibodies (anti-thyroid peroxidase and anti-thyroglobulin) were positive in 67.1% of the patients for both antibodies, with 92.9% positive for at least one antibody. Thyroid ultrasonography showed features compatible with AIT in 93.1% of those patients who underwent imaging. [-thyroxine treatment was initiated in 68.4% of the patients either at diagnosis or during follow-up. After a median follow-up period of 1.79 years (range 0-8.93), treatment was discontinued in five patients with overt hypothyroidism, three of whom achieved sustained euthyroidism while one developed subclinical hypothyroidism. Some patients with subclinical hypothyroidism showed spontaneous recovery of thyroid function. Conclusion: Pediatric AIT demonstrates variable presentations and dynamic thyroid function changes, necessitating personalized monitoring.