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Lesh R, Hellums R, Pichardo P, Wong J, Pellitteri P, Purdy N, Stavrides K, Haugen TW. Thyroid Abscess: A Case Series and Literature Review. Ear Nose Throat J 2023:1455613221150128. [PMID: 36603543 DOI: 10.1177/01455613221150128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE In this retrospective case series, we chronicle six patients presenting with acute suppurative thyroiditis (AST) with progression to thyroid abscess in a single institution. METHODS Patients ranged in age from 16 to 74 years of age. The most common presenting symptoms were progressive unilateral neck pain, swelling, and odynophagia. Other symptoms included hoarseness and systemic signs of infection. Diagnosis of thyroid abscess was made with a CT scan of the neck, fine needle aspiration, and/or incision and drainage (I&D). RESULTS Management included antibiotic therapy, I&D, and thyroidectomy. All patients were successfully treated except for one who developed mediastinitis and died. CONCLUSION A complete literature review was performed to determine etiologies, common findings, and management of similar cases.
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Affiliation(s)
- Randy Lesh
- Department of Otolaryngology-Head and Neck Surgery, Geisinger Medical Center, Danville, PA, USA
| | - Ryan Hellums
- Department of Otolaryngology-Head and Neck Surgery, Geisinger Medical Center, Danville, PA, USA
| | - Priscilla Pichardo
- Department of Otolaryngology-Head and Neck Surgery, Geisinger Medical Center, Danville, PA, USA
| | - Jeff Wong
- Department of Otolaryngology-Head and Neck Surgery, Geisinger Medical Center, Danville, PA, USA
| | - Phillip Pellitteri
- Department of Otolaryngology-Head and Neck Surgery, Geisinger Medical Center, Danville, PA, USA
| | - Nicholas Purdy
- Department of Otolaryngology-Head and Neck Surgery, Geisinger Medical Center, Danville, PA, USA
| | - Kevin Stavrides
- Department of Otolaryngology-Head and Neck Surgery, Geisinger Medical Center, Danville, PA, USA
| | - Thorsen W Haugen
- Department of Otolaryngology-Head and Neck Surgery, Geisinger Medical Center, Danville, PA, USA
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Huang D, Zhi J, Zhang J, Qin X, Zhao J, Zheng X, Gao M. Relationship Between Thyroid Autoantibodies and Recurrence of Papillary Thyroid Carcinoma in Children and Adolescents. Front Oncol 2022; 12:883591. [PMID: 35756669 PMCID: PMC9213685 DOI: 10.3389/fonc.2022.883591] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background Numerous studies reported connection between papillary thyroid carcinoma (PTC) and thyroid autoantibody in adults, but few of them have investigated whether there is a similar link in children and adolescents. The purpose of this research was to explore the relationship between clinicopathological features, prognosis and preoperative thyroid peroxidase antibody (TPOAb) as well as thyroglobulin antibody (TgAb) status in children and adolescents with PTC. Methods This study retrospectively reviewed 179 patients of PTC who underwent a thyroidectomy from January 2000 to June 2021 at Tianjin Medical University Cancer Hospital. We compared preoperative TgAb and TPOAb status with the clinicopathological features and prognosis of children and adolescents with PTC in different age groups. Results Patients with positive preoperative TPOAb and TgAb had lower recurrence rate in the younger group (P = 0.006, 0.047, respectively). Patients with positive TPOAb preoperatively had normal level of preoperative Tg and less cervical LNM than patients with negative TPOAb in children and adolescents (P < 0.05). Positive TPOAb preoperatively of PTC patients had a longer median DFS (113.4 months) than negative TPOAb (64.9 months) (P = 0.009, log-rank). Univariate analyses showed age, maximal tumor size, T stage, multifocality, lateral LNM and N staging were predictors for cancer recurrence in children and adolescents (P<0.05). Cox regression analysis found younger age (HR 0.224, P < 0.001), lateral LNM (HR 0.137, P = 0.010), N stage (HR 30.356, P < 0.001) were independent risk factors for recurrence. Conclusions Our study found that presence of preoperative TPOAb and TgAb could serve as novel prognostic factors for predicting recurrence of PTC in children.
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Affiliation(s)
- Dongmei Huang
- Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Jingtai Zhi
- Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Jinming Zhang
- Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Xuan Qin
- Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Jingzhu Zhao
- Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Xiangqian Zheng
- Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Ming Gao
- Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China.,Department of Thyroid and Breast Surgery, Tianjin Union Medical Center, Tianjin, China.,Tianjin Key Laboratory of General Surgery Inconstruction, Tianjin Union Medical Center, Tianjin, China
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Shimura K, Yoshizaki K, Hasegawa Y. Higher serum thyroid autoantibody value is a risk factor of hypothyroidism in children and young adults with chronic thyroiditis. Clin Pediatr Endocrinol 2022; 31:152-158. [PMID: 35928388 PMCID: PMC9297167 DOI: 10.1297/cpe.2022-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/09/2022] [Indexed: 11/29/2022] Open
Abstract
Thyroid function in patients with chronic thyroiditis (CT) varies depending on the
clinical course. Serum antithyroglobulin antibody (TgAb) and antithyroid peroxidase
antibody (TPOAb) levels may be used to predict hypothyroidism in CT. In this retrospective
cohort study, patients with CT, defined as having a high TgAb or TPOAb value, were divided
into a hypothyroid group (HG) and euthyroid group (EG), after a mean follow-up of 2.5
years. The definitions of the two groups was based on the maximum TSH value from the
initial measurement to the most recent follow-up: HG was defined as TSH 10.0 μIU/mL or
higher, and EG was defined as TSH < 10.0 μIU/mL. There were 20 and 113 patients in the
HG and EG, respectively. There were no significant differences in age, sex, underlying
diseases, or TgAb and TPOAb levels between the groups. Receiver operating characteristic
curve analyses of TgAb and TPOAb values for predicting thyroid function showed areas under
the curve of 0.714 and 0.757, respectively. The value with the highest diagnostic accuracy
was 106 IU/mL for TgAb and 16 IU/mL for TPOAb. Thus, TgAb > 106 IU/mL and TPOAb > 16
IU/mL may predict hypothyroidism in children and young adults with CT.
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Affiliation(s)
- Kazuhiro Shimura
- Department of Endocrinology and Metabolism, Tokyo Metropolitan Children’s Medical Center, Tokyo, Japan
| | - Kanako Yoshizaki
- Department of Endocrinology and Metabolism, Tokyo Metropolitan Children’s Medical Center, Tokyo, Japan
| | - Yukihiro Hasegawa
- Department of Endocrinology and Metabolism, Tokyo Metropolitan Children’s Medical Center, Tokyo, Japan
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Kryczyk-kozioł J, Zagrodzki P, Paśko P. Wpływ suplementacji diety selenem na przebieg autoimmunologicznego zapalenia tarczycy – przegląd badań klinicznych przeprowadzonych w populacji europejskiej. POSTEP HIG MED DOSW 2021; 75:683-95. [DOI: 10.2478/ahem-2021-0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstrakt
Wiele obserwacji wskazuje na zależność między zmniejszonymi zasobami selenowymi organizmu a różnymi schorzeniami tarczycy, w tym także autoimmunologicznym zapaleniem tarczycy (AZT). W większości prac poświęconych temu zagadnieniu zmiana stężenia przeciwciał anty-TPO była główną miarą oceny skuteczności suplementacji selenem (Se) diety pacjentów z AZT. Stężenie przeciwciał anty-TPO ma wpływ na intensywność nacieków limfocytarnych w gruczole tarczowym i stopień jego uszkodzenia, dlatego zmniejszenie ich stężenia w wyniku zwiększonego spożycia Se może się przyczynić do skuteczniejszego leczenia AZT. W części prac omówionych w artykule ewaluacja immunoregulacyjnego działania Se w przebiegu AZT została rozpatrzona w odniesieniu do szerszego zakresu parametrów biochemicznych i immunologicznych (głównie dotyczy to zmian w wytwarzaniu cytokin i chemokin). Wielu autorów potwierdziło wpływ Se na zmniejszanie stężenia przeciwciał anty-TPO, jednak wyniki wszystkich prac nie są jednoznaczne. Przyczyną rozbieżności może być odmienny stopień wysycenia tarczycy Se i jodem w różnych grupach pacjentów, różny stopień zaawansowania choroby, różne dawki Se podawanego pacjentom, stosowanie lub niestosowanie jednoczesnej terapii L-tyroksyną oraz polimorfizmy pojedynczych nukleotydów (SNP) występujące w genach kodujących poszczególne selenobiałka.
Na podstawie dostępnej literatury można wnioskować, iż zagadnienie dotyczące roli Se w AZT jest nadal słabo poznane. Istnieje potrzeba kontynuowania badań oceniających wpływ suplementacji diety Se na przebieg tej choroby, które powinny obejmować poza anty-TPO inne parametry kliniczne. Dopiero wyniki tak szeroko ujętych badań mogą być pomocne w formułowaniu nowych wytycznych dotyczących wspomagania leczenia przez odpowiednią modyfikację diety z uwzględnieniem suplementacji Se.
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Casto C, Pepe G, Li Pomi A, Corica D, Aversa T, Wasniewska M. Hashimoto's Thyroiditis and Graves' Disease in Genetic Syndromes in Pediatric Age. Genes (Basel) 2021; 12:222. [PMID: 33557156 DOI: 10.3390/genes12020222] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 01/30/2021] [Accepted: 02/01/2021] [Indexed: 12/18/2022] Open
Abstract
Autoimmune thyroid diseases (AITDs), including Hashimoto’s thyroiditis (HT) and Graves’ disease (GD), are the most common cause of acquired thyroid disorder during childhood and adolescence. Our purpose was to assess the main features of AITDs when they occur in association with genetic syndromes. We conducted a systematic review of the literature, covering the last 20 years, through MEDLINE via PubMed and EMBASE databases, in order to identify studies focused on the relation between AITDs and genetic syndromes in children and adolescents. From the 1654 references initially identified, 90 articles were selected for our final evaluation. Turner syndrome, Down syndrome, Klinefelter syndrome, neurofibromatosis type 1, Noonan syndrome, 22q11.2 deletion syndrome, Prader–Willi syndrome, Williams syndrome and 18q deletion syndrome were evaluated. Our analysis confirmed that AITDs show peculiar phenotypic patterns when they occur in association with some genetic disorders, especially chromosomopathies. To improve clinical practice and healthcare in children and adolescents with genetic syndromes, an accurate screening and monitoring of thyroid function and autoimmunity should be performed. Furthermore, maintaining adequate thyroid hormone levels is important to avoid aggravating growth and cognitive deficits that are not infrequently present in the syndromes analyzed.
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Tang S, Yang M, Zhang D, Tong YJ, Xin Y. Clinical Characteristics and Follow-Up of 19 Children With Hashimoto's Thyroiditis Aged Below 3 Years: A Single-Center Retrospective Analysis. Front Endocrinol (Lausanne) 2021; 12:737527. [PMID: 34539581 PMCID: PMC8446657 DOI: 10.3389/fendo.2021.737527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 08/19/2021] [Indexed: 11/28/2022] Open
Abstract
AIM To analyze the clinical characteristics of Hashimoto's thyroiditis (HT) in children below 3 years of age in order to improve the understanding of the disease, avoid misdiagnosis, and achieve early diagnosis and treatment. METHODS The study retrospectively analyzed the clinical data of 19 patients diagnosed with HT in the first three years of life. RESULTS The patients (12 female, 7 male) had an average age of 26.1 ± 8.2 months (range 10-36 months). At presentation, one patient had euthyroidism, ten had hypothyroidism, seven had subclinical hypothyroidism, and one had hyperthyroidism. The most common reasons for doctor's visits were thyroid enlargement (21.1%), global developmental delay (21.1%), and routine thyroid function tests in patients with type 1 diabetes (26.3%). Sixteen patients provided follow-up data, and the mean follow-up time was 23.31 ± 16.44 months (range 1-48 months). In the hypothyroidism group, one patient stopped levothyroxine (LT4) treatment after 2 months; the remaining patients had been treated with LT4 since their diagnosis. In the subclinical hypothyroidism group, one patient whose thyroid function returned to normal after 1 month of being diagnosed was not treated. The remaining patients received LT4 treatment at their diagnosis or during follow-up. The patient with hyperthyroidism was treated with methimazole after diagnosis, but treatment was discontinued 11 months later and LT4 was initiated 26 months after diagnosis. One in four patients with global developmental delay approached normal mental development after LT4 treatment. Four in six patients with short stature achieved height catch-up. CONCLUSION At their initial HT diagnosis, most of the children showed hypothyroidism or subclinical hypothyroidism. Children with global developmental delay require continual screening, even if the thyroid function is normal after birth, to determine whether they have HT-induced hypothyroidism. Thyroxine replacement could partially relieve the clinical manifestations of hypothyroidism and early diagnosis and treatment are essential for improving patient prognosis.
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Falhammar H, Wallin G, Calissendorff J. Acute suppurative thyroiditis with thyroid abscess in adults: clinical presentation, treatment and outcomes. BMC Endocr Disord 2019; 19:130. [PMID: 31791298 PMCID: PMC6889346 DOI: 10.1186/s12902-019-0458-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 11/18/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Abscess in the thyroid gland is a rare but severe infectious disease. The condition can have anatomic or iatrogenic underlying causes. If untreated it could be fatal. Pathogens vary considerably. Treatment is intravenous antibiotics, drainage, and sometimes surgery. METHODS The electronic medical records of all adult patients with acute thyroiditis 2003-2017 treated at the Karolinska University Hospital (catchment area 2 million) in Sweden were systematically reviewed. RESULTS Five patients were found in the catchment area. One patient from another region but known to us was also included. Thus, six patients (aged 28-73 years) were included in the study. Median length of hospital stay was 7.5 days (4-79 days). All were treated with antibiotics (intravenous n = 5, oral n = 1). Total antibiotic treatment duration was 13.5 days (10-41 days). Blood cultures were positive in three (streptococcus pneumonia, streptococci sanguineous, pepto streptococci), deep tissue culture in three (Escherichia coli, Candida, Hemophilic influenza) and no positive culture at all in two. Drainage was used in three patients. All patients recovered without recurrences. Surgery was performed twice in the acute phase in one. There was no recurrence during 7 years (3-12) of follow-up, but one patient died after three years (severe heart failure and pneumonia). CONCLUSION Thyroid abscess in adults is extremely rare nowadays in the developed world. With prompt antibiotic therapy, drainage and in some cases thyroidectomy the prognosis seems favourable.
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Affiliation(s)
- Henrik Falhammar
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Endocrinology Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
| | - Göran Wallin
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Deptartment of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Jan Calissendorff
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
- Department of Endocrinology Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden.
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korkmaz Ö, Özen S, Gökşen D, Darcan Ş. Clinical charecteristics and follow- up findings of the cases Pediatric Hashimoto’ Thyroiditis- Retrospective a single centre experience. Konuralp Tıp Dergisi 2019. [DOI: 10.18521/ktd.432200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Giordano P, Urbano F, Lassandro G, Bianchi FP, Tolva A, Saracco P, Russo G, Notarangelo LD, Gabelli M, Cesaro S, Wasniewska M, Faienza MF. Role of antithyroid autoimmunity as a predictive biomarker of chronic immune thrombocytopenia. Pediatr Blood Cancer 2019; 66:e27452. [PMID: 30270575 DOI: 10.1002/pbc.27452] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/29/2018] [Accepted: 08/20/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Immune thrombocytopenia (ITP) is an acquired immune-mediated disorder characterized by isolated thrombocytopenia. Pediatric ITP patients are prone to develop autoantibodies such as antithyroglobulin (TG) and antithyroperoxidase (TPO), even in the absence of clinical signs of autoimmune disease. The aim of this multicenter retrospective study was to evaluate (1) the prevalence of positivity of antithyroid antibodies (TPO and TG) in a large cohort of pediatric patients with chronic ITP; (2) the role of autoimmune thyroiditis as a prognostic factor for chronicity of ITP. PROCEDURE For this retrospective study, we collected data from patients diagnosed as affected by chronic ITP between 2011 and 2014 in six centers belonging to the Italian Association of Pediatric Haematology and Oncology (AIEOP). RESULTS From the analysis of data, we found a significantly higher prevalence of antithyroid antibodies in children with chronic ITP (11.6%) than in the pediatric population (1.2%-1.3%). No correlation has been found between the platelet count and the prevalence of positive antithyroid antibodies at any detection time of the study. CONCLUSIONS The results of our study demonstrated that (1) the prevalence of positivity for antithyroid antibodies (anti-TPO and anti-TG) in pediatric patients with chronic ITP results is significantly higher than in the pediatric population; (2) autoimmune thyroiditis does not seem to play a role as a prognostic factor for chronicity of ITP in pediatric patients.
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Affiliation(s)
- Paola Giordano
- Department of Biomedical Sciences and Human Oncology, University "A.Moro,", Bari, Italy
| | - Flavia Urbano
- Department of Biomedical Sciences and Human Oncology, University "A.Moro,", Bari, Italy
| | - Giuseppe Lassandro
- Department of Biomedical Sciences and Human Oncology, University "A.Moro,", Bari, Italy
| | | | - Alessandra Tolva
- Pediatric Onco-Hematology Unit, IRCCS Foundation, Policlinico San Matteo, Pavia, Italy
| | - Paola Saracco
- Pediatric Hematology, University Hospital Città della Salute e della Scienza, Torino, Italy
| | - Giovanna Russo
- Clinical and Experimental Medicine, Pediatric Hemato-Oncology Unit, University of Catania, Catania, Italy
| | | | - Maria Gabelli
- Pediatric Onco-Hematology Unit, University of Padova, Padova, Italy
| | - Simone Cesaro
- Pediatric Onco-Hematology Unit, Woman and Child Hospital, University of Verona, Verona, Italy
| | - Malgorzata Wasniewska
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
| | - Maria Felicia Faienza
- Department of Biomedical Sciences and Human Oncology, University "A.Moro,", Bari, Italy
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Crisafulli G, Gallizzi R, Aversa T, Salzano G, Valenzise M, Wasniewska M, De Luca F, Zirilli G. Thyroid function test evolution in children with Hashimoto's thyroiditis is closely conditioned by the biochemical picture at diagnosis. Ital J Pediatr 2018; 44:22. [PMID: 29415743 PMCID: PMC5804084 DOI: 10.1186/s13052-018-0461-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 02/02/2018] [Indexed: 11/19/2022] Open
Abstract
ᅟ Aim of this commentary is to summarize the salient literature views on the relationships between presentation and evolution patterns of thyroid function in children with Hashimoto’s thyroiditis (HT). According to the most recent reports, children with HT and subclinical hypothyroidism (SH) are more prone to the risk of developing severe thyroid dysfunctions over time, if compared to those presenting with euthyroidism. In contrast, children presenting with HT and either overt or subclinical hyperthyroidism are incline to exhibit a definitive resolution of the hyperthyroid phase within some months, although there is a wide variability between the different individuals. The natural history of frank hypothyroidism in the children with HT has never been investigated so far, since in these cases an immediate onset of replacement treatment is mandatory. Conclusions 1) a deterioration of thyroid status over time may be observed especially in the children presenting with SH, but also in those presenting with euthyroidism; 2) a definitive resolution of the hyperthyroid phase is generally observed in those presenting with either overt or subclinical hyperthyroidism.
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Affiliation(s)
- Giuseppe Crisafulli
- Department of Human Pathology in Adulthood and Childhood, University of Messina, Via Consolare Valeria, 98124, Messina, Italy
| | - Romina Gallizzi
- Department of Human Pathology in Adulthood and Childhood, University of Messina, Via Consolare Valeria, 98124, Messina, Italy
| | - Tommaso Aversa
- Department of Human Pathology in Adulthood and Childhood, University of Messina, Via Consolare Valeria, 98124, Messina, Italy
| | - Giuseppina Salzano
- Department of Human Pathology in Adulthood and Childhood, University of Messina, Via Consolare Valeria, 98124, Messina, Italy
| | - Mariella Valenzise
- Department of Human Pathology in Adulthood and Childhood, University of Messina, Via Consolare Valeria, 98124, Messina, Italy
| | - Malgorzata Wasniewska
- Department of Human Pathology in Adulthood and Childhood, University of Messina, Via Consolare Valeria, 98124, Messina, Italy
| | - Filippo De Luca
- Department of Human Pathology in Adulthood and Childhood, University of Messina, Via Consolare Valeria, 98124, Messina, Italy.
| | - Giuseppina Zirilli
- Department of Human Pathology in Adulthood and Childhood, University of Messina, Via Consolare Valeria, 98124, Messina, Italy
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Aversa T, Corrias A, Salerno M, Tessaris D, Di Mase R, Valenzise M, Corica D, De Luca F, Wasniewska M. Five-Year Prospective Evaluation of Thyroid Function Test Evolution in Children with Hashimoto's Thyroiditis Presenting with Either Euthyroidism or Subclinical Hypothyroidism. Thyroid 2016; 26:1450-1456. [PMID: 27541075 DOI: 10.1089/thy.2016.0080] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND 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. AIM 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. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Tommaso Aversa
- 1 Department of Pediatrics, University of Messina , Messina, Italy
| | - Andrea Corrias
- 2 Department of Pediatrics, University of Turin , Regina Margherita Children's Hospital, Turin, Italy
| | | | - Daniele Tessaris
- 2 Department of Pediatrics, University of Turin , Regina Margherita Children's Hospital, Turin, Italy
| | - Raffaella Di Mase
- 3 Department of Pediatrics, University "Federico II ," Naples, Italy
| | | | - Domenico Corica
- 1 Department of Pediatrics, University of Messina , Messina, Italy
| | - Filippo De Luca
- 1 Department of Pediatrics, University of Messina , Messina, Italy
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Dong LQ, Sun XM, Xiang CF, Wu J, Yu P. Hashimoto's thyroiditis and papillary carcinoma in an adolescent girl: A case report. Mol Clin Oncol 2016; 5:129-131. [PMID: 27330783 DOI: 10.3892/mco.2016.895] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 02/26/2016] [Indexed: 11/06/2022] Open
Abstract
Hashimoto's thyroiditis with thyroid cancer in childhood is not as common in the adult population. Hashimoto's thyroiditis is an autoimmune disease associated with autoantibodies, and the association between Hashimoto's thyroiditis and papillary carcinoma of the thyroid remains controversial. The present study reported a 15-year-old adolescent girl with the diagnosis of Hashimoto's thyroiditis with thyroid cancer. With the complexity of the clinical manifestations of Hashimoto's thyroiditis, it can be expressed as not only hyperthyroidism or hypothyroidism, but also normal thyroid function. The long-term treatment, and for children with thyroid cancer, early diagnosis is particularly difficult. In the present case, the diagnosis of Hashimoto's thyroiditis is primarily based on clinical manifestations, anti-thyroglobulin antibody and anti-thyroid microsomal antibody. The only diagnostic imaging ultrasound was negative. The present study discussed the possible reason and the identification of this unique case of Hashimoto's thyroiditis with thyroid cancer.
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Affiliation(s)
- Li-Qun Dong
- Department of Pediatrics, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Xiao-Mei Sun
- Department of Pediatrics, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Cheng-Fa Xiang
- Department of Pediatrics, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Jin Wu
- Department of Pediatrics, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Ping Yu
- National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
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De Luca F, Santucci S, Corica D, Pitrolo E, Romeo M, Aversa T. Hashimoto's thyroiditis in childhood: presentation modes and evolution over time. Ital J Pediatr 2013; 39:8. [PMID: 23363471 PMCID: PMC3567976 DOI: 10.1186/1824-7288-39-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 01/23/2013] [Indexed: 11/22/2022] Open
Abstract
Aim of this survey is to report the most recent views about Hashimoto’s thyroiditis (HT) natural history according to the different presentations. In children presenting with either euthyroidism or subclinical hypothyroidism HT spontaneous course is frequently characterized by a trend towards deterioration of thyroid function, whereas in those presenting with overt hyperthyroidism a definitive resolution of hyperthyroid phase is to be expected. Another possible even though unusual outcome of HT is the conversion to Graves’ disease.
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Affiliation(s)
- Filippo De Luca
- Department of Pediatrics, University of Messina, Padiglione NI Policlinico Universitario, Via Consolare Valeria, 98125 Messina, Italy.
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14
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Crisafulli G, Wasniewska M, Ascenti G, Rulli I, Zirilli G, Aversa T, De Luca F. Acute suppurative thyroiditis disclosing diagnosis of thyroid cancer in a boy. J Endocrinol Invest 2008; 31:1137-8. [PMID: 19246984 DOI: 10.1007/bf03345666] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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