Long-term outcome with Hashimoto’s thyroiditis

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Hashimoto’s thyroiditis (HT) is a common cause of goiter in adolescents, especially those with other disorders such as Turner syndrome, celiac disease, and type 1 diabetes mellitus. Some children with HT experience a gradual deterioration in thyroid function, ultimately developing clinical hypothyroidism. Others, however, may remain euthyroid for decades. Recognizing those at risk for deterioration early in their course, in theory, could permit rapid detection of hypothyroidism and initiation of treatment before significant clinical disease were to occur.

In this issue of The Journal, Radetti et al report serial measurements in 160 children with HT in an attempt to provide information on this risk. Although there was a greater risk of deterioration in thyroid function for children with goiter and with elevations in thyroglobulin antibodies, there was no combination of findings which could prove predictive in the individual patient. Thus, it still appears that careful, serial examination must be continued indefinitely in all these children as they grow.